Clonazepam: What Is It and What's it Used For?

Drugs for the treatment of epileptic seizures are mainly focused on reducing the brain hyperactivation characteristic of this disease.

Written and verified by the doctor Nelton Abdon Ramos Rojas.

Last update: 19 August, 2022

Clonazepam is a benzodiazepine drug that acts on the central nervous system (CNS). In particular, it exerts anticonvulsant, anxiolytic, sedative, hypnotic, and mood-stabilizing effects. It’s therefore often used in the treatment of seizure disorders and panic attacks.

It’s available as tablets and orally dissolving tablets (which dissolve in the mouth). These can be found under the names “Clonax,” “Clonagin,” “Diocam,” “Klonopin,” “Rivotril,” “Zatrix,” and others.

How does it work? What are its side effects?

Let’s take a look.

Important information about Clonazepam

Clonazepam is a prescription medication because of the high risk of side effects. Because of its properties, some people tend to misuse it.

Therefore, first of all, it is important to pay attention to the following:

• Clonazepam use can cause severe breathing difficulties when taken at the same time as certain medications. These include opioids for cough or pain. The same effect may occur if taken with alcoholic beverages or other drugs.
• Taking this medication at a higher dose or more often can lead to addiction, overdose, or death. Therefore, it’s essential to follow your doctor’s advice. This means stopping treatment when your doctor tells you to stop.
• Some people report having suicidal thoughts while on this drug. If this is the case, tell your doctor.
• Do not stop treatment suddenly for any reason. Also, don’t reduce your dose without a doctor’s advice. These situations can lead to a reaction of physical dependence, which translates into physical symptoms such as unusual movements, ringing in the ears, anxiety, memory problems, seizures, depression, among others.
• Symptoms of the underlying disease may also worsen.

Under what conditions are this drug prescribed?

Clonazepam is currently used alone or in combination with other drugs in the treatment of seizure disorders. This includes epilepsy, non-convulsive status epilepticus, and minor motor seizures of childhood, such as those caused by Lennox-Gastaut syndrome and infantile spasm. It’s also FDA-approved for panic disorders.

However, as detailed in a publication in the National Center for Biotechnology Information , it also has other off-label uses, such as in the treatment of mania, restless legs syndrome, insomnia, REM sleep behavior disorder, and tardive dyskinesia.

Clonazepam mechanism of action

Clonazepam is a long-acting benzodiazepine. It binds to brain receptors called BZ (benzodiazepine) receptors and activates them. In other words, it’s a BZ receptor agonist.

BZ receptors enhance GABA activity, which is decreased during epileptic seizures. The increase in this brain inhibition slows the spread of epileptic seizures, although it doesn’t act on the epileptogenic focus.

The main route of administration of this drug is oral. Once consumed, its action begins 20 to 60 minutes later. The effects tend to vary between adults and children, and can last up to 12 hours.

In the blood, the drug crosses the blood-brain barrier and reaches the nervous system. In addition, it’s metabolized in the liver and largely eliminated in the urine. Therefore, its dose should be adjusted when administered to patients with liver failure.

However, it should be noted that this drug can cross the placental barrier. Therefore, its use during pregnancy should be considered very carefully by medical professionals.  Possible harmful effects to the fetus include hypothermia and respiratory depression.

It’s also contraindicated during lactation.