A case report of preferential effectiveness of clonazepam over lorazepam in the management of a case of alprazolam withdrawal

Benzodiazepines (BZDs) remain the mainstay in the management of withdrawal arising out of BZD use disorders. The choice of detoxifying agent is determined by the duration of action and also by the metabolic properties of the drug. Very rarely, we consider the chemical properties of the drug that we choose, though occasionally that may have profound clinical impact on the outcome. In this case report, we present the case of alprazolam withdrawal that was ineffectively managed by lorazepam and finally salvaged by the use of clonazepam. The chemical properties of the molecules involved and their clinical importance in the decision-making process have been subsequently reviewed.