Clonazepam is a benzodiazepine derivative that have anticonvulsant, muscle relaxant and potent anxiolytic (anti anxiety effects) properties which is marketed by Roche under the trade name of Klonopin in the United States, under the trade name of Rivotril in Australia, Brazil and Canada and under the trade name of Kriadex in Mexico, the other names that are Ravotril, Rivatril or Clonex are known as such throughout the rest of the world.

Clonazepam, though classified as a high potency benzodiazepine is sometimes used as a second line treatment of epilepsy and is also used in the treatment of panic disorder.  There are other situations where clonazepam may be used as treatment in cases like managing the visual effects of HPPD (Hallucinogen persisting perception disorder), treating many forms of parasomnia, restless leg syndrome in which clonazepam is used as a third line treatment option and rapid eye movement behavior disorder responds well to low doses of clonazepam.

For the treatment of panic disorder, clonazepam short term effectiveness has been shown in controlled clinical trials whereas some long term trials have shown successful use of clonazepam for up to three years without the development of tolerance but these trials were not placebo controlled.

There are side effects to any substance that is taken, the side effect of clonazepam varies, and the most common side effects are drowsiness and interference with the cognitive and motor performance of a person.  The less common side effects consists of irritability and aggression, psychomotor agitation, lack of motivation, loss of libido, impaired coordination, impaired balance, dizziness and cognitive impairment which includes hallucinations, short term memory loss and anterograde amnesia which is common with high doses.

The occasional side effects could result in serious dysphoria, psychiatric side effects, inducing seizures or increase frequency of seizures, personality changes, behavioral disturbance, confusion and ataxia which is a lack of coordination.  The rare side effects consist of psychosis, incontinence, and liver damage, paradoxical behavior disinhibition such as rage, excitement, impulsivity and seizures becoming worse.

The long term effects of clonazepam can include depression, disinhibition and sexual dysfunction.  Being a receptor agonist, one third of people who are treated with clonazepam for longer than four weeks, develop a dependence on the drug and can experience withdrawal syndrome when the dosage is reduced and for this reason it is not generally recommended for the long term management of epilepsies.  Although increasing the dosage can overcome the effects of tolerance but tolerance to the increased dosage may happen and may increase adverse effects.  The mechanism of tolerance includes receptor desensitization and alterations in gene transcription coding.

There are special precautions to be taken when used in the elderly because of the risk of drug accumulation, risk of impairments and falls also special precautions should be taken if used in pregnant, alcohol or drug dependent people and people with co morbid psychiatric disorders.  Also precautions with children, clonazepam is not recommended for use in children under eighteen years old because it can be extremely hazardous.

Clonazepam will impair a person’s ability to drive or operate machinery and using alcohol can intensify the central nervous system depressing effects of the drug.  It has been shown to cause both psychological and physical dependence and if occurs it should be measured and calculated under the supervision of a qualified healthcare professional in order to reduce the intensity of the withdrawal symptoms.

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