Clonazepam



Clonazepam 770
Photo by: Nikolai Sorokin

Definition

Clonazepam belongs to a group of drugs called benzodiazepines. Benzodiazepines are medications that help relieve nervousness, tension, symptoms of anxiety, and some types of seizures by slowing the central nervous system. In the United States, clonazepam is sold under brand name Klonopin.

Purpose

Although clonazepam is approved by the United States Food and Drug Administration (FDA) for the treatment of panic disorder and some types of epilepsy, it is also used to treat social phobia , mania, and post-traumatic stress disorder .

Description

Clonazepam belongs to a group of drugs called benzodiazepines. Benzodiazepines are sedative-hypnotic drugs that help to relieve nervousness, tension, anxiety symptoms, and seizures by slowing the central nervous system. To do this, they block the effects of a specific chemical involved in the transmission of nerve impulses in the brain , decreasing the excitement level of the nerve cells.

When clonazepam is used to treat panic disorder, it is more sedating than alprazolam , another benzodiazepine drug used to treat panic disorder. However, unlike alprazolam, clonazepam may trigger depressive episodes in patients with a previous history of depression. In people who experience social phobia, treatment with clonazepam reduces the rate of depression. The use of clonazepam for social phobia is considered off-label use—a use that is legal, but not specifically approved by the FDA.

Clonazepam comes in 0.5 mg-, 1 mg-, and 2 mg tablets.

Recommended dosage

For panic disorder, the initial recommended dose is 0.25 mg twice daily. This dose can be increased every three days in increments of 0.125–0.25 mg twice daily. The target dose for panic disorder is 1.0 mg per day, although some people benefit from doses up to a maximum of 4 mg per day. When a person stops taking clonazepam, the drug should be gradually discontinued by decreasing the dose by 0.125 mg twice daily every three days.

Although clonazepam is not FDA-approved for the treatment of post-traumatic stress disorder, doses in the range of 0.25–3 mg daily appears to help treat symptoms of this disorder. Daily dosages for the treatment of social phobia range from 1.0–2.5 mg, while the dosage to control mania may be as high as 10 mg daily.

Precautions

Women who are pregnant should not use clonazepam, because it may harm the developing fetus. Clonazepam should never be taken by people who have had an allergic reaction to it or another benzodiazepine drug such as diazepam (Valium). People with narrow-angle glaucoma or severe liver disease should not take clonazepam. People who have kidney disease may need to take a reduced dosage of the drug. Saliva production may increase while taking clonazepam. Because of this, people with respiratory disease or an impaired gag reflex should use clonazepam with close physician supervision.

Because clonazepam is a nervous system depressant, it should not be taken with other such depressants, such as alcohol, other sedatives, sleeping pills, or tranquilizers. People taking clonazepam may feel unusually drowsy and mentally sluggish when they first start taking the drug. They should not drive, operate dangerous machinery, or engage in hazardous activities that require mental alertness until they see how clonazepam affects them. This excessive sedation usually goes away after a short time on the drug.

People who have underlying depression should be closely monitored while taking clonazepam, especially if they are at risk for attempting suicide .

Side effects

The main side effects of clonazepam are sedation, dizziness, impaired coordination, depression, and fatigue . Some people experience decreased sex drive while taking clonazepam.

A small number of people develop sinus problems and upper respiratory tract infections while taking clonazepam. One of the side effects of clonazepam may be increased salivation. This may cause some people to start coughing while taking clonazepam. Clonazepam may also cause anorexia and dry mouth. It may cause either constipation or diarrhea. There are a few reports of clonazepam causing menstrual irregularities or blurred vision.

Interactions

Clonazepam may increase the sedative effects of other drugs that depress the central nervous system such as certain pain strong medicines (opiates such as codeine, oxycodone, hydromorphone) and antihistamines (found in many cold and allergy medications). The sedative effect is also increased if clonazepam is taken with alcohol.

Disulfiram (Antabuse), a medication used to treat alcohol dependence, increases the effect of clonazepam. Medications that make clonazepam ineffective include phenobarbital, phenytoin, carbamazepine , theophylline, rifampin, and rifabutin.

Resources

BOOKS

Kaplan, Harold. Comprehensive Textbook of Psychiatry. Williams and Wilkins, 1995.

Lacy, Charles F. Drug Information Handbook. Lexi-Comp, Inc. 2002.

PERIODICALS

Valenca, Alexandre. "Smoking and Panic Disorder." Psychiatric Service 52, no. 8 (2001):1105-06.

Ajna Hamidovic, Pharm.D.



User Contributions:

slavco g
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Aug 26, 2009 @ 7:07 am
Dear,

My sister receive Clonazepam for last 10 days.
But when she started with this drug, she is slippy all the day?
Whether Clonazepam can force this situation?

Sincerely,
Y Johnson
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Dec 3, 2009 @ 4:16 pm
My daughter who has profound disabilities both mental and physical,
has been taking clonazepam (2.5mg) at night for years, she is also taking carbamazepine which I have just now discovered is should not be taken together.

Her seizures seem to be increasing of late and I am wondering whether our doctor should
change her medication.
tina snyder
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Dec 16, 2009 @ 6:06 am
i just recently started getting tremers and shaking could this drug be doing it?i have been taking this drug for over a year.
Mari
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Dec 18, 2009 @ 2:14 pm
I have been taking clonazepam for the last 2 years. I started with 0.25 then 1mg twice a day for my panic disoder social phobia and chronic anxiety. This is the only medication that kills my anxiety and panic. I'm trying to cut the dose to not be laying on it as it is addictive. It does work for anxiety. Tina everyone has diff reactions to medications personally for me it dont make me shaky but u always have to let the doctor know. Hope this was helpful
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May 10, 2010 @ 2:14 pm
I have a severe itch on my hands and sometimes on my arms and legs. I have been told that this could be a nervous disorder and Clonazepam would help. Do you think it would help or just make me sleepy in the daytime. I always take it at night for sleep. Your reply would be greatly appreciated.

Thanks in advance,
Elaine Cone
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Jan 27, 2011 @ 8:20 pm
I have been taking colanzepam(Rivotril 2mg) for the last 8Years. Usually I take it in the night.
But when I stop taking it for a single day I am not getting sleep at all.please advise
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Aug 18, 2011 @ 11:11 am
My mother has alziemers she would not sleep at all and I am talking about days without sleep.so I ask her Dr.for help give be something for her to sleep.Cause if she does not sleep I do not sleep cause I take care of her 24-7.I am her care taker.So he gave her Clonazepam 0.5mg.O it works we have tried so many other thing that did not work.Finally some thing that works.But now she sleeps 10to12 hours.I don't know if I would rather have her jitterig or a sleep.She was so jittering before.that just the way Alziemers is.She has had for 4yrs now.
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Aug 31, 2011 @ 5:17 pm
Dear JOsie,

Let her sleep! I say. You are taking on the hardes job of your life...

I keep waking up am todl I have mania. Clonazapam saves my life. I feel "normal." They have finally given me a decent dose for me (3 mg/day). Everyone is so scared of becoming addicted, but if you use the med and feel well, why are you scared. Take it as directed and disclose everything to your doc...stop worrying so much. If you ask me they are afraid of their licences and thFDA, not about us being well. If you sell it, take more than your rx, hoard it...then you should be worried...just my opinion , of course!

Chatty Kathy
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Sep 1, 2011 @ 7:07 am
How long does clonazepam stay in your system, week, 2 weeks.
mCon
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Sep 4, 2012 @ 9:21 pm
I have myoclonic seizure disorder. I consider myself a positive person. Recently I was put on Clonazepam to calm my tremors. (The tremors were really bad.) I take 1MG at bedtime. I still have tremors.
What can I do to decrease my tremors?


There are times I feel stressed.

As for fatigue (anyone can be tired depending on work habits) I normally sleep 2-4 hours Saturday and or Sunday each week. This is a norm for me and always has.
Jaypeel
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Sep 7, 2012 @ 3:03 am
I have a friend who suffers from panic attacks he has been put on 2mg of clonazepam 3 times daily all he does is sleep wot is I'n this drug and is it addictive.
stef
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Nov 25, 2012 @ 3:15 pm
I have been prescribed clonazepam for many years, I found out I was pregnant and stopped the medications right away and haven't touched them since the entire pregnancy up to date. However, I am now 26 weeks pregnant and had a horrible panic attack today. I took 2 mg of clonazepam during the anxiety attack which is what I was prescribed before I got pregnant and I'm wondering if it would do any damage to the fetus or harm the baby if the clonazepam was only taken once and one day only and not taken at all during the rest of the pregnancy? If anyone would have some information on this I'd appreciate it, thanks.
Ed
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Jul 9, 2013 @ 11:11 am
I have 3 'mental disorders' and one of the drugs I am prescribed is clonazepam, a member of the benzodiazepine class of drugs (includes Valium, Xanax, Ativan etc.). All this information is freely available on the internet, particularly the prescribing information. Currently I take 3 mg/day, 2mg upon waking and 1 or 2mg around 4-5:00 pm. It is sedating initially, but this goes away after awhile, although if you take more than you are used to you will get sleepy. I have been taking clonazepam about 11 years.
I like to distinguish between dependence and addiction. Dependence is when your body requires the drug for normal function. Benzodiazepine use creates dependence. Withdrawal from long term use is often difficult and protracted as the body adjusts to not having it. Addiction is where you hoard medicine, doctor shop to get more than your own doctor will give you, take way more than you are prescribed, buy it off the street etc. They are two very different conditions. It works well for me, I have no desire to abuse or increase the dose so I don't worry about it.
Clonazepam has a half-life of about 30 hours. That means if you take a 5 mg dose, 30 hours later there will still be 2.5 mg in the body, in 60 hrs. from the dose 1.25 mg, 90 hours from the dose 0.75 mg etc.
All psychiatric drugs work by altering the neurotransmitters function in the brain. Benzodiazepines like clonazepam enhance the function of a neurotransmitter called GABA. The system for ramping up or down the nervous system involves Glutamate (ramp up) and GABA (ramp down). This is why clonazepam helps anxiety etc.
For suhas, this is really a discussion you should be having with your doctor. But thinking of how it works I would say headache-no, pain-no, tension, maybe as it is a tranquilizer. Benzodiazepines are also known as minor tranquilizers, anti-psychotics are sometimes called major tranquilizers, but have far more severe potential side effects.
paul Maxwell
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Aug 6, 2013 @ 1:13 pm
I was put on this med well over a year ago for "minor" anxiety. I was not warned of the side effects or checked on while taking it. I am 75. I went back to the dr. with what I later read were just about all the side effects. The dr. then DOUBLED the med and I was feeling TERRIBLE FOR MONTHS. I couldn't get an apt with the dr. so I got an internal med. dr. and he was shocked that I was taking this med and started decreasing my dosage 1/2 pill every 2 or so months. I am now down to 1/2 pill from the 2 I was on. I am so upset that not only did he prescribe this med for my not very serious problem but when I told him how bad I was feeling - he DOUBLED it. People are amazed at the change in my behavior and attitude. I talked to the pharmacist and she said not one pharmacist she knows approves of this med or any ending in "pam". I will be off it in several weeks. What can I expect as a result of taking it and having all these problems?? PM
nick
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Sep 4, 2013 @ 5:17 pm
Can clonazepam mask the affects of alcohol?
If someone is over legal limit can they appear to be sober when they have taken clonazepam?
Thea
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Feb 10, 2014 @ 2:14 pm
In 2009, I was diagnosed with moderate/ severe depression while living in Vancouver,bc. In 2005 while still living in Edmonton, ab my doctor at the time had put me on clonazepam for a period of two years and then it was decreased prior to moving. Was off the drug for 1 and 1.2 years, then was put back on it by my vancity doctor and she added "paxol". Paxol was a nightmare as i had increased thoughts of suicide, was a nervous reck,had started to plan ways of ending it. Went to the pharmacist, they advised me to call my doc and get in right away, then the pharmacist would call within 24 hours to do a check up. This pharmacist took the time to ask me and record the details of what was happening, also advised that I collaborate with the doctor, find a new drug, get off of paxol and perhaps find a new one. Saw doctor next day, she gradually decreased the paxol I was off within two weeks and have been taking clonazepam pretty steady since then. All of the paxol /clon thing happened on the west coast. Been back in Edmonton, ab for five years now and having problems with findng gps who have enough knowledge about what they are doing and also ones who will listen to their patient. We live inside our bodies 2 4 hours a day so we are gonna have a good gage of how our bodies react to medication. Long story short after my experience with paxol i don't wanna try another anti depressant and clon has been a god send, it works to for me. I just requested with my doctor to increase the dosage and he refused. So I will doctor surf, hoard, consider buying on line and do alot research before trusting a gp. I have found that medical professionals in Vancity,bc work together as opposed to acting as one seperate entity, I have a continuing disdain with the alberta healthcare system.
Margaret Needham
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Oct 15, 2014 @ 7:07 am
My husband has Alzheimers; diagnosed 4 1/2 years ago. He takes 20MG Citalopram at bedtime for sleep & one tablet(2MG) of Clonazepam at bedtime. Lately he has been awake most of the night; does not know where he is & just paces the house. Are these two meds to be taken together?

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