Health

Clonazepam

Benzodiazepines such as Clonazepam have a fast onset of action and high effectiveness rate and low toxicity in overdose but have drawbacks due to adverse reactions including paradoxical effects, drowsiness, and cognitive impairment. Cognitive impairments can persist for at least 6 months after withdrawal of clonazepam; it is unclear whether full recovery of memory functions occurs.

Clonazepam is primarily prescribed for epilepsy, but is also prescribed for panic and anxiety, which are indication of abnormal electrical activity in the brain.

How it Works

In general, Clonazepam produces mild sedation by depressing activity in the central nervous system (the brain and spinal cord). In particular, clonazepam appears to enhance the effect of gamma-aminobutyric acid (GABA), a natural chemical that inhibits the firing of neurons and dampens the transmission of nerve signals, thus decreasing nervous excitation.

[blockquote align=”right”]Cognitive Remediation Therapy (CRT) is designed to improve neurocognitive abilities such as attention, working memory, cognitive flexibility and planning, and executive functioning which leads to improved social functioning. (See Clonazepam long term side effects on cognition.)[/blockquote]

Side Effects

Serious

Difficulty concentrating, outbursts of anger, other behavior problems, depression, hallucinations, low blood pressure (causing faintness or confusion), memory impairment, muscle weakness, skin rash or itching, sore throat, fever and chills, sores or ulcers in throat or mouth, unusual bruising or bleeding, extreme fatigue, yellowish tinge to eyes or skin.

Common

Drowsiness, loss of coordination, unsteady gait, dizziness, lightheadedness, slurred speech.

Less Common

Change in sexual desire or ability, constipation, false sense of well-being, nausea and vomiting, urinary problems, unusual fatigue.

Possible Interactions

Herbs, Vitamins, Minerals

Hawthorn may react antagonistically to clonazepam. Valerian and Kava Kava may interact additively (drowsiness): may exacerbate central nervous system depression (avoid this combination). Kola nut, Siberian ginseng, mate, and ma huang may blunt the benefits of this medicine. While St. John’s Wort is indicated for anxiety, it is also thought to increase (induce) cytochrome P450 enzymes and will tend to blunt clonazepam effectiveness.

Alcohol

Alcohol may increase the depressant effects of this medicament on the brain. It is advisable to avoid alcohol completely throughout the day and night-if it is necessary to drive or to engage in any hazardous activity.

Marijuana

Increased sedation and significant impairment of intellectual and physical performance.

Discontinuation

Do not stop clonazepam suddenly if it was controlling any type of seizure, or if it was taken for more than 4 weeks. Dosing should be slowly decreased (tapered) to prevent a withdrawal syndrome.

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