Clonazepam
Clonazepam is one of the most potent benzodiazepine derivatives, and it is used both to prevent or relieve seizures and to control anxiety disorders.
Clonazepam is quite commonly prescribed for:
- the relief of acute cases of epilepsy where the benefits of short-term therapeutic use under controlled circumstances outweigh the risks — Clonazepam is less effective in treating seizures in the young and it has had some adverse effects on cognitive function;
- anxiety and panic disorders;
- the treatment the first stages of mania alongside medications such as lithium; and
- restless legs syndrome.
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How does Clonazepam work?
Clonazepam enhances the properties of Gamma-Aminobutyric Acid (GABA) which is an inhibitory neurotransmitter found in the central nervous system rather than in the brain. The ability to control seizures comes from the effect on the sodium channels in the brain which slows their action and so reduces any electrical spike that might be associated with a seizure.
It also has an effect on the level of the serotonin, another neurotransmitter associated with mood. This property, in combination with its natural sedative effect, calms anxiety states. In short bursts and in combination with an SSRI, Clonazepam has also been found effective in treating obsessive-compulsive disorder and clinical depression — the combination reduces some of the side effects associated with SSRIs.
What are the side effects?
In the short term, Clonazepam tends to make you drowsy — which is increased if you also consume alcohol. You should therefore avoid any activity involving danger unless you are alert. Note that the nicotine in cigarettes reduces Clonazepam’s effectiveness. The less serious side effects are:
- excessive tiredness or weakness, sometimes accompanied by a slight loss of co-ordination;
- an upset stomach and diarrhoea; and
- unusual changes in your appetite.
More serious symptoms are:
- a change in your mood to one of excitement or restlessness;
- difficulty urinating or constipation;
- your vision blurs; or
- you lose interest in sex or experience erectile dysfunction.
In very rare cases, it can cause:
- more severe loss of physical co-ordination and an inability to sit still;
- difficulty in breathing;
- an irregular heartbeat; or
- a seizure.
Although benzodiazepines remain valuable medications, there are risks that if you take too high a dose for too long, you may become physically and psychologically dependent. Once dependent, you will experience difficult withdrawal symptoms when you try to stop.
You should always discuss these risks with your regular physician if you propose to take Clonazepam for more than two or three weeks. This need for consultation is reinforced by the clearly shown difficulty that, as your body becomes more tolerant of Clonazepam, it becomes less effective. This means that Clonazepam is almost useless over the longer term. Thus, in principle, you should not give this medication to a child or an older person, and you should not take it if you have had problems of addiction to alcohol or other medications.
You should tell your physician if you are, or plan to become pregnant, or you are breast-feeding.
Do not have surgery or dental treatment involving the use of an anaesthetic without disclosing the fact that you are taking Clonazepam.