Clonazepam is a benzodiazepine derivative and a highly potent amnestic, anticonvulsant and anxiolytic. It is marketed by Roche in the US as Klonopin, and as Rivotril in Europe, Canada, South America, and Australia.
As with other benzodiazepines, Klonopin is thought to act by stimulating the action of GABA on the central nervous system (CNS). Due its strong anxiolytic properties and euphoric side effects, it is said to be one of the “highly potent” benzodiazepines. Though they are invaluable in treating anxiety disorders, benzodiazepines have some potential for abuse and may lead to dependence or addiction. Klonopin’s sedative effects are relatively weak, compared to its strong anxiolytic and anticonvulsant effects.
Klonopin is often prescribed for panic attacks, anxiety disorders, epilepsy, restless leg syndrome (RLS), initial treatment of mania, hallucinogen persisting perception disorder, chronic fatigue syndrome (CFS), Tourette’s syndrome, night terrors, and (rarely) insomnia.
Clonazepam Warnings and Side Effects
Clonazepam should not be used by patients with ataxia, severe hypoventilation; acute narrow-angle glaucoma; severe sleep apnea; severe liver deficiencies; myasthenia gravis; acute intoxication with alcohol, narcotics, or other psychoactive substances; and hypersensitivity or allergy to any drug in the benzodiazepine class.
Treatment is usually not indicated in children and adolescents under 18 years old, except to treat epilepsy, and for pre/postoperative treatment.
Patients at a high risk for misuse, abuse, and dependence are patients with a history of drug abuse or dependence; emotionally unstable patients; those with severe personality disorders, such as Borderline Personality Disorder (BPD); and patients with chronic pain or other physical disorders. Long-term treatment with Klonopin should never be ceased abruptly, but rather withdrawn gradually over a period of weeks or months.
Symptoms of clonazepam overdose include mental confusion, hypotension, impaired motor functions, somnolence, impaired motor functions, dizziness, and coma. Unless combined with other drugs, coma or other severe central nervous system manifestations are rare, and the mortality rate linked to clonazepam poisoning is very low. As with other benzodiazepines, overdose symptoms can be reversed with flumazenil.