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Benzo Equivalency Chart


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4 replies to this topic

#1 elocinintherain

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Posted 28 August 2007 - 02:52 PM

I searched forever for this information for my own needs recently, because I just wasn't satisfied with being told that 1=1. Anyways, for your consumer satisfaction needs, here it is:

http://www.dr-bob.org/tips/bzd.html

From: Clinical Handbook of Psychotropic Drugs, 4th revised edition, Bezchlibnyk-Butler et al. editors (Clarke Insitute of Psychiatry, Toronto), Hogrefe & Huber.

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Benzodiazepine DOSE Comparative Time to peak plasma level Half-life



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Alprazolam .5 1 - 2 9 - 20
Bromazepam 3.0 .5 - 4 8 - 30
Chlordiazepoxide 25 1 - 4 24 - 100
Clonazepam .25 1 - 4 19 - 60
Clorazepate 10 variable 1.3 - 120 * (unreliable absorption)
Diazepam 5 1 - 2 30 - 200 *
Estazolam 1 .5 - .6 8 - 24
Flurazepam 15 .5 - 1 40 - 250 *
Halazepam 40 1 - 3 30 - 96 *
Ketazolam 7.5 3.2 30 - 200
Lorazepam 1 2- 4 8 - 24
Nitrazepam 2.5 .5 - 7 15 - 48
Oxazepam 15 2 - 3 3 - 25
Prazepam 10 2.5 - 6 30 - 100
Quazepam 7.5 1.5 39 - 120 *
Temazepam 10 2.5 3 - 25
Triazolam .25 1 - 2 1.5 - 5

* metabolites

------------------------------------------------------------------------------------
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#2 StrungOutOnLife

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Posted 19 September 2007 - 04:18 PM

This deserves a pin.
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#3 Silver

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Posted 01 January 2008 - 04:20 PM

This chart (from Arana & Rosenbaum) is another good one. It matches the one I find in Kaplan & Sadock's text.
The oft-cited Ashton chart can be found here. I'll put my money on A&R, though.
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#4 Suboxer

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Posted 27 May 2010 - 02:22 PM

The thread originator's chart is only one of many - it may be the Heather Ashton chart, but I do not precisely recall. If so, it is about the equivalency of benzodiazepines for the purpose of tapering and withdrawal, which she herself acknowledges is not the same as therapeutic equivalency. As we all know, some BZDs are more sedating (think flurazepam, estazolam, or nitrazepam), others more anxiolytic, (think clonazepam or lorazepam), along with different occurences the other three effects: amnesic (think midazolam), anti-epileptic (think clonazepam) and muscle relaxant (think diazepam).

These differing effects are due to a different binding profile of the specific drug at subunits of the GABA-A-BZD receptor. Sedative-hypnotic effects are seen in BZDs that are GABA-A-BZD-α1-selective (as well as Z-drugs which are also α1 selective), etc. Benzodiazepines, unlike barbiturates, are not direct agonists of the GABA-A receptor. They are what is called a "positive allosteric modulator," which essentially means they affect the action of the endogenous neurotransmitter in such a way that it becomes more potent when both the endogenous neurotransmitter and the PAM are bound to the same receptor. BZDs make GABA more potent. A "positive allosteric modulator" of the mu-opioid receptor (none have been developed, and according to current knowledge, it is likely impossible to develop one - although endorphine reuptake inhibitors are in the works) would bind to a tertiary site on the mu-opioid receptor and increase the activity of the endorphines (for analogy).

A more thorough chart, compiling several different authors' list of equivalencies, is much better. Different authors using different methods have come up with vastly differing comparisons of relative potency. Ashton compares clonazepam 500µg of to diazepam 10mg; several other authors put that figure between 1mg and 2mg, and others as high as clonazepam 4mg to diazepam 10mg.

Benzodiazepine Equivalency Chart (bottom of the page).

There is also a PDF that compares indications, interactions, elimination half-lives, and several other parameters available. Caveat: it only covers benzodiazepines available in Canada. Uploaded to RapidShare:

Canadian Benzodiazepine Comparison Chart (PDF Download)

Edited by Suboxer, 27 May 2010 - 03:10 PM.

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Dx: (currently under revision) schizoaffective disorder - bipolar type, GAD, PD w/o agoraphobia, opioid dependency, PTSD, HPPD, temporal lobe epilepsy, refractory insomnia, paranoid personality disorder.

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#5 DancingQueen1918

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Posted 01 April 2012 - 08:17 AM

That's very interesting. When I was in the hospital my (idiot horrible) doctor used 1mg of Xanax, Klonopin and Ativan interchangeably. No wonder.1mg of Ativan did nothing for me when I'm used to 1mg of Klonopin at home. :/
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