What You Need to Know

The effects and chemical structures of Etizolam and Xanax are very similar, but there are some differences. They are both central nervous system (CNS) depressants that are used to treat anxiety and panic disorders. They also have sedative qualities and can be used as sleep aids, but they may cause daytime drowsiness. They can also cause intoxication that’s similar to alcohol, including loss of motor control, memory loss, the release of inhibitions, slurred speech, and respiratory depression.

But with so many similarities, how do they differ? Here are some of the most significant differences between etizolam and Xanax:


The two drugs work in the brain in very similar ways, but they’re actually in different chemical classes. Xanax is a benzodiazepine, which has a chemical structure that involves a benzene ring touching a diazepine ring. Other drugs in this class are Valium and Ativan.

Etizolam also has benzene and diazepine rings, but they aren’t touching. Where the benzene ring resides in a benzodiazepine, there’s another structure called a thiophene ring. This difference puts etizolam in a category called thienotriazolodiazepine.


In the United States, Xanax is classified as a Schedule IV substance by the federal government. In other words, it has a low potential for abuse, and it’s currently accepted for medical use in the United States. It’s also considered to have a low risk of physical and psychological dependence if it’s abused.

However, benzodiazepines do have a significant risk of physical dependence and abuse. Still, it’s considered to be limited compared to more addictive drugs that are more strictly scheduled. It can be obtained with a prescription, but otherwise, it’s illegal to buy and sell it without authorization.

Etizolam is not approved for medical use in the U.S., though it is commonly prescribed in Japan and some European countries. From a federal standpoint, the drug isn’t scheduled, but it’s considered a Schedule I drug in some states, which means it’s illegal to buy or sell it.

However, the legal ambiguity of the drug in the U.S. allows it to be sold on the gray market, which is the name for the market in which substances are sold by circumventing existing drug laws. According to the U.S. Drug Enforcement Administration (DEA), Etizolam can be bought online or in stores if it’s labeled as a “research chemical.”

Effects And Medical Uses

Xanax and etizolam have similar effects, and both can cause anxiolysis (anxiety relief), hypnosis, sedation, and anticonvulsant effects. Xanax is most commonly prescribed as a remedy for anxiety and panic disorders. In some cases, it can be used to treat seizures.

Etizolam has a wide variety of uses outside of the U.S. In low and standard doses, it most commonly affects anxiolysis, but sedation and hypnosis can be more common in higher doses. In Japan, it’s marketed as a treatment for anxiety, pain, depression, sleep disorders, and even headaches.

Why Is Etizolam Used?

Most people have heard of Xanax, but etizolam is less common. But the two drugs are used for many of the same medical treatments.

Etizolam is primarily used to treat insomnia and anxiety disorders, and it’s especially good at relieving anxiety. But it’s less likely to have hypnotic effects. In higher doses, it can cause hypnosis, sedation, loss of motor control, and other effects consistent with sleep aids.

On the other hand, Xanax is primarily used to treat anxiety and panic disorders, and other medications are typically used if a sleep disorder is involved.

Xanax has a longer duration of action, which can drowsiness the next day if it’s used as a sleep aid. Etizolam has a similar half-life, and it will be reduced to half of the original concentration in your blood after six hours. However, its effects peak at three hours and start to wane after that. Still, it may cause next-day drowsiness with a high enough dose.

Whether it’s used for insomnia or anxiety, etizolam is intended for short-term use. Like Xanax, the prolonged, consistent use of the drug can cause chemical dependence and addiction. If you keep using the drug, your brain will start adapting to its presence and integrate it into your normal brain chemistry.

Furthermore, it may stop producing its own inhibitory chemicals, and it may even produce excitatory chemicals to counteract the drug and balance your brain chemistry. For that reason, both etizolam and Xanax are used as a temporary therapeutic treatment.

While etizolam is used in Japan and parts of Europe, it’s not approved for use by the Food and Drug Administration in the U.S., but it is legal in a few states. It’s considered a Schedule I drug, due to its likelihood to be abused.

How Much Etizolam Is Equal To Xanax?

Etizolam is active at a very low dose: about 0.2 to 0.5 milligrams. Using even half a milligram more than necessary can have considerably boosted effects. A typical clinical dose is around 0.5 to 2.0 milligrams per day, depending on the individual patient, the means of administration, and the intended use.

According to the DEA, etizolam is about ten times more potent than diazepam (Valium). Xanax is prescribed at similar levels, though starting doses will usually be slightly smaller for the treatment of anxiety. In medical settings, Xanax can be prescribed at much higher doses, especially for severe panic disorders and seizures.

Using a high dose of either drug is more likely to cause dangerous side effects, such as memory loss, a lack of inhibitions, or respiratory depression. Very high doses can be dangerous, as respiratory depression can slow or stop breathing to the point of oxygen deprivation, brain damage, coma, and death.

It’s worth noting that doses of similar strengths may not produce the same effects. They’re different drugs, and they may have different effects on the brain and body, even in equally strong doses.

If the two substances are combined, they can potentiate each other, which means they can work together to compound their effects. This impact can increase your likelihood of experiencing memory loss, heavy sedation, respiratory depression, and even death. Many of the fatal cases of Xanax and etizolam overdoses involve other CNS depressants such as benzodiazepines, opioids, or alcohol.

Etizolam Dosage For Anxiety

In a double-blind, placebo-controlled study conducted with 36 patients diagnosed with anxiety, patients were given one tablet twice daily of either 0.50 g or 0.25 mg of Etizolam for five weeks. Assessments were made at entry, and by day 21 and day 35, 26 patients showed that the 0.50 mg dosage of Etizolam produced a dramatic improvement in those with anxiety and other depressive symptoms. The drug was well-tolerated, with few side effects reported, minus some daytime drowsiness, which was mild to moderate. 

Although the number of individuals tested produced good results, this dosage can still vary from person to person. The age, sex, weight, and severity of anxiety will all play a role in the dosages. However, 0.25 mg and 0.50 mg seem to be the best dose to ease anxiety symptoms. Of course, you must speak with your doctor to determine the best amount for you.

Etizolam Half-Life

Etizolam is a drug that’s absorbed rapidly and peak plasma levels can be achieved anywhere from 30 minutes to two hours, meaning it has an elimination half-life of about 3.4 hours. The duration of action can range anywhere from five to seven hours. Etizolam boasts potent hypnotic properties and is commonly compared with other short-acting benzodiazepine drugs. 

Is Etizolam A Sleeping Pill?

Etizolam is marketed as a sedative-hypnotic drug with insomnia-reducing, muscle-relaxing, and anti-anxiety properties. The medication is used as a sleeping pill on some occasions, despite its ability to relieve anxiety. The drug is chemically similar to Valium and produces comparable central nervous system depressant effects. However, when tested, it was found that Etizolam is six to ten times more potent than Valium and achieving pharmacological effects.

Warning Signs of Etizolam

As a Schedule I drug, simply possessing the substance is in violation of federal law and could be a warning sign of abuse. Prolonged use of the drug despite adverse effects can also be taken as a warning sign of misuse or abuse. Negative effects of Etizolam include the following:

  • Depression
  • Confusion
  • Excessive sedation or sleepiness
  • Impaired coordination
  • Impaired cognitive function
  • Slurred speech
  • Changes to vision
  • Changes in libido
  • Tremors

Since Etizolam is not marketed in the United States, it can still be found online. If you witness suspicious packages arriving at your house, this could be another red flag of abuse. Other warning signs a person has developed an addiction to Etizolam include the following:

  • Increased isolation
  • Decreased work productivity or poor performance
  • Increased absences at school or a drop in grades
  • Avoiding personal responsibilities
  • Needing more of the medication to experience the desired effects
  • Going through Etizolam withdrawal when you cut back or stop using the drug

Etizolam Overdose

Unfortunately, the instances of Etizolam overdose have been increasing recently. Negative outcomes are more likely when a drug like Etizolam is used in conjunction with other central nervous system depressants like alcohol. The combination of these drugs causes sedation, respiratory depression and could result in fatal overdoses. All known cases of Etizolam-related deaths at the time involved other substances like opioids or alcohol. 

Although little information has been published about Etizolam overdose, it’s similar to other benzodiazepine overdose symptoms and includes:

  • Slowed pulse
  • Extreme drowsiness
  • Confusion
  • Muscle weakness
  • Severely altered or stopped breathing
  • Coma

If you witness these symptoms, you must immediately consider it a medical emergency and call 911. The sooner you can get help, the lower the chances are of long-term damage or death. Stay on the phone with the operator as they will provide you with necessary and life-saving advice. 

Comparing Xanax And Etizolam

Etizolam and Xanax are somewhat similar, but thienodiazepines, like Etizolam, have been researched much less than benzodiazepines like Xanax. There have been suggestions that thienodiazepines are less addictive than benzodiazepines. Even if that were the case, they are not immune from causing dependence through abuse.

Etizolam has been shown to have a less sedative effect than benzodiazepines, but their anxiolytic effect is similar.

Benzodiazepines are Schedule IV substances as classified by the DEA. Thienodiazepines are not currently scheduled in the United States. There has been controversy surrounding benzodiazepines and their classification. Schedule IV substances are known for having a low potential for abuse, but benzodiazepines are among the most abused drugs today. Dependence can arise quickly with continued use.

The World Health Organization released a peer review on etizolam that highlights their views on scheduling, and it did not receive the same recommendation as benzos. The drug presents enough dangers that it must be regulated when you take into account its growing illicit use in the United States.

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