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Clonazepam is a widely prescribed anticonvulsant of the benzodiazepine class for the treatment of certain types of seizures. It is also used as an anti-anxiety medication to relieve panic attacks. The common factor in the two seemingly unrelated uses is the drug’s ability to tamp down abnormal electrical activity in the brain. The Food and Drug Administration (FDA) approved Clonazepam (brand name, Klonopin) for the treatment of seizures in 1975. The chemically-identical, generic version of the drug known as Clonazepam is also available.
A lot of clinical experience has accumulated with the use of the drug for the therapy of various types of epileptic seizures both in adults and children. However, with the advent of newer anticonvulsant drugs, Klonopin is most often prescribed as an add-on drug in combination with other anticonvulsant medications. In current therapeutic practice, the drug is used to treat absence seizures usually in combination with Depakote (valproate). Clonazepam is highly effective for the treatment of juvenile myoclonic epilepsy and progressive myoclonic epilepsy by itself or in combination with valproate. For the treatment of partial seizures, the anticonvulsant drugs of choice are carbamazepine or phenytoin largely replacing Klonopin.
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The most common side effects of Clonazepam are drowsiness, dizziness, loss of balance and muscle coordination (ataxia), cognitive and memory problems, behavioral changes involving loss of normal inhibition and increased risk-taking. The sides effects are usually most pronounced at the initiation of therapy, and tend to subside with continued treatment. These problems can be minimized by starting at low dosage, and gradually increasing until the therapeutic level is reached. Discontinuing the drug also must be done gradually to avoid potentially severe withdrawal symptoms.
For elderly patients and pregnant women the drug carries additional risks. In the elderly there is an increased likelihood of falling, and at higher doses the drug-induced memory loss and confusion can mimic the symptoms of Alzheimer’s disease. The drug is known to increase the chances of birth defects, but untreated epilepsy itself also increases the risk of congenital malformations, so the drug should be given during pregnancy only when the benefits outweigh the risks.
Klonopin is also used to control panic attacks and severe anxiety disorders. The drug works to slow down an overstimulated central nervous system by down-regulating the activity of gamma-aminobutyric acid (GABA) receptors in the brain thereby decreasing nervous agitation, and producing a sense of calm and relaxation. Klonopin is potentially addictive like other drugs of the benzodiazepine class including Xanax (Alprazolam), Valium (diazepam), and Clonazepam (lorazepam), and all are classified as controlled substances.