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KLONOPIN is an anti-anxiety medication in the benzodiazepine family, the same family that includes diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), flurazepam (Dalmane), and others. Clonazepam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits brain activity. It is believed that excessive activity in the brain may lead to anxiety or other psychiatric disorders. Clonazepam is primarily used for treating panic disorder and preventing certain types of seizures.
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The initiation or abrupt withdrawal of Clonazepam in patients with epilepsy or a history of epileptic seizures may precipitate the development of seizures or an epileptic condition. Several studies have shown that about 30% of patients who received anticonvulsant therapy for three months had a decrease in drugs anticonvulsant activity. In some cases, adjusting the dose allowed to restore this activity. The risk of drug dependence increases when using high doses and with increasing duration of use and in patients with a history of drug and alcohol dependence. If it is necessary to discontinue treatment with Clonazepam, withdrawal should be made gradually by reducing the dose to reduce the risk of withdrawal syndrome. In this case, the simultaneous prescription of another antiepileptic agent is necessary. With abrupt withdrawal after long-term use or taking high doses, withdrawal syndrome occurs, characterized by agitation, fear, autonomic disturbances, insomnia, in severe cases - mental disorders.
In women planning to become pregnant, therapy with anticonvulsants should not be discontinued if the drug is used to prevent seizures because there is a high probability of epileptic status with associated hypoxia and risk to life. In individual cases, when the severity and frequency of epileptic seizures are low. It is reasonable to assume that withdrawal of therapy will not result in serious life-threatening conditions. Women should withdraw the treatment before and during pregnancy. Note that even moderately severe seizures can be harmful to the fetus. In terms of using Clonazepam for children, the risk and benefit should be evaluated because of the possibility of adverse side effects on the child's physical and mental development, including delayed. Avoid drinking alcoholic beverages during treatment with Clonazepam. Use with caution together with drugs that cause CNS depression. Concomitant use of CNS-depressant drugs or alcohol increases the likelihood of severe adverse reactions. Avoid driving a vehicle and perform work requiring quick psychomotor reactions during treatment with Clonazepam and within 3 days after its completion.
Increased risk of drug-related mortality from concomitant use with opioids. Suicidal thoughts or behavior (monitor). Depression. May increase or precipitate tonic-clonic seizures. Compromised respiratory function (eg, COPD, sleep apnea). Porphyria. Monitor LFTs, CBCs during long-term therapy. Assess patient's risk for abuse, misuse, addiction prior to and during therapy. Avoid abrupt cessation. Withdraw gradually. Drug or alcohol abusers. Renal impairment. Elderly. Labor & delivery. Pregnancy. Nursing mothers.
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