Clonazepam: Helpful or harmful?

Prescription medicines Medication safety Medicine Anticonvulsants Teens

The bottom line

Clonazepam is a benzodiazepine prescribed for seizures and panic disorder. It enhances the effect of GABA, an inhibitory neurotransmitter in the brain. Side effects include drowsiness, dizziness, difficulty concentrating, poor coordination, and mood changes. Overdoses can cause coma and respiratory depression. Abuse and long-term use can lead to physical dependence and addiction.

Prevention Tips

Store clonazepam up, away and out of reach of children.
Take as prescribed.
Do not take more than prescribed or more often than prescribed.
Store at room temperature, away from heat and moisture, in a dry, dark place. Do not put in direct sunlight.
If you are prescribed the oral disintegrating tablet, keep it in original foil pouch until you are ready to take it.
Do not stop clonazepam suddenly.
Be aware of potential for interactions with other drugs and herbal supplements. You can use an online interaction checker for help or talk to your doctor.

This Really Happened

A 30-month-old girl was stumbling, falling, and drowsy so her parents took her to the hospital. She was drowsy, but otherwise the neurologic exam was normal. Ten to twelve hours after hospitalization, she became comatose with decreased muscle tone and reflexes. Her family then stated that clonazepam tablets were found on the ground, but they had no idea how many were missing. Laboratory findings were normal. EKGs showed an increased heart rate with prolonged QTc interval. Serum clonazepam concentration15 hours after presentation was elevated. She had a fluctuating mental status alternating between coma and alertness. She was given a dose of the benzodiazepine antidote flumazenil. She slowly improved and was asymptomatic with a normal EKG 72 hours after ingestion.

What is clonazepam prescribed for?

Clonazepam is a benzodiazepine prescribed for the treatment of panic disorders and seizures, including absence, akinetic, and myoclonic seizures. Off-label uses include acute mania, tremor, and restless legs syndrome. Its brand name is Klonopin, but generic formulations are available.

How does clonazepam work?

Clonazepam enhances the inhibitory neurotransmitter GABA (gamma-aminobutyric acid) resulting in in central nervous system depression. It also inhibits other neuronal systems. Clonazepam can reduce feelings of anxiety and make you feel calmer.

What are the side effects of clonazepam?

Since clonazepam is a depressant, side effects include drowsiness, dizziness, difficulty concentrating, and poor coordination. It may cause changes in mood including lack of motivation, depression, agitation, and delusions. Overdoses can cause lethargy, slurred speech, unsteady walking, decreased reflexes, small pupils, coma, and respiratory arrest. Heart rate, blood pressure, and body temperature may decrease. Allergic reactions including rashes and swelling are possible.

Long-term use can result in physical dependence. If clonazepam is suddenly stopped, withdrawal symptoms may occur, which can be fatal. Withdrawal symptoms include anxiety, irritability, nausea, vomiting, tremors, sweating, hallucinations, delusions, delirium, psychosis, and seizures. If you are discontinuing clonazepam, it needs to be tapered slowly.

Is clonazepam a controlled substance?

Clonazepam is a Schedule IV controlled substance. Like other benzodiazepines, clonazepam can be abused. Street names include K and K-Pin. Abuse and long-term use can lead to physical dependence and addiction.

What should I avoid while taking clonazepam?

Do not drive or take part in activities that require clear thinking and good motor skills until you know what effect clonazepam has on you. Avoid drinking alcohol and taking drugs that cause central nervous system depression, such as opioids, sleep medication, muscle relaxants, and first-generation sedating antihistamines (such as Benadryl). Avoid herbal and dietary supplements that are sedating such as valerian or passionflower. If you are lying down or sitting, get up slowly to avoid a drop in blood pressure that can cause dizziness.

What should I do if someone accidentally takes clonazepam or takes too much clonazepam?

If someone accidentally takes clonazepam or takes too much, get help right away. Use the webPOISONCONTROL^® online tool or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.