Clonazepam is an anticonvulsant that belongs to the benzodiazepine group. It is used to treat mental illness and epilepsy.
What is clonazepam?
Clonazepam is an anticonvulsant that comes from the benzodiazepine group. It is used to treat mental illness and epilepsy. Clonazepam belongs to the group of drugs that have both sedative and anticonvulsant effects. It belongs to the group of benzodiazepines. The drug promotes sleep and has a positive effect on anxiety states. However, it is mainly used for the treatment of epileptic seizures. The first benzodiazepine, called chlordiazepoxide, was marketed in 1960 by the pharmaceutical company Hoffmann-La Roche. In the years that followed, other benzodiazepines were developed with different effects. Finally, starting in 1964, clonazepam was also patented and became available in the United States of America in 1975.
Pharmacological effects
As a benzodiazepine, clonazepam has the property of binding to certain receptors in the brain that are specific to this group of substances. Communication between nerve cells in the brain occurs with the help of special messenger substances called neurotransmitters. At the point of contact, a nerve cell releases neurotransmitters that have either an inhibitory or excitatory effect. This in turn causes the inhibition or excitation of the downstream nerve cell, whose perception of the neurotransmitter is through the receptors, which are docking sites. However, the nerve cell can only ever produce and subsequently release a certain type of neurotransmitter. Among the most important inhibitory neurotransmitters is GABA (gamma-aminobutyric acid). By taking clonazepam, the inhibitory effects of GABA on various nerve nodes can be enhanced. In this way, clonazepam ensures the dampening of brain excitability, which in turn can counteract the tendency to epileptic seizures. This process makes clonazepam well suited as an anticonvulsant, sedative, and sleep-inducing drug. Unlike barbiturates, the risk of respiratory depression is less pronounced with benzodiazepines such as clonazepam. On the other hand, however, there is a higher risk of benzodiazepine abuse because of rapid habituation to clonazepam. Following ingestion of clonazepam, the active ingredient is released into the blood via the intestines. After one to four hours, the drug reaches its highest level in the body. Because clonazepam has a fat-soluble effect, it can accumulate primarily in the brain. The liver converts the benzodiazepine into breakdown products that no longer have any effect. They pass out of the body primarily through the urine as well as the stool.
Medical use and application
Clonazepam is mainly used for the treatment of various forms of epilepsy. In this context, the drug is also suitable for treating babies and children. Furthermore, the active ingredient is used to treat movement disorders such as restless legs syndrome, sitting restlessness, or spasms of the masticatory muscles, as well as anxiety, social phobias, or sleepwalking. However, the drug should not be taken for more than a few weeks. Otherwise, there is a risk of becoming dependent on clonazepam. In addition, the drug loses its effect after some time. Sometimes, however, long-term treatment with clonazepam is indispensable, for example, in cases of severe epilepsy that cannot be treated effectively by other means. Clonazepam is usually administered in the form of tablets. Up to a dose of 250 milligrams of clonazepam per tablet pack, the drug is available on prescription from pharmacies. For higher doses, the Narcotics Act takes effect, so a special narcotic prescription is required. It is recommended not to exceed a total daily dose, which is 8 milligrams. Clonazepam drops are also available for patients with swallowing disorders and children under the age of six. Generally, treatment is started with a low dose of clonazepam. In the further course of therapy, a gradual increase takes place. Treatment with clonazepam must not be stopped abruptly, otherwise there is a risk of seizures. For this reason, a gradual reduction of the dose takes place.
Risks and side effects
Therapy with clonazepam may result in side effects that are similar to those of other benzodiazepines. These include primarily fatigue, prolongation of reaction time, dizziness, decreased muscle tension, muscle weakness, and unsteadiness of gait. Furthermore, redness of the skin, itching, pigment changes, temporary hair loss, hives, urinary incontinence, stomach problems, nausea, headaches, a lack of blood platelets, and loss of libido are also within the realm of possibility. Rarely, an allergic reaction or shock may also occur. Elderly patients need to take special care because of the muscle relaxant effects, as there is an increased risk of falls in them. There are also some contraindications. For example, clonazepam must not be administered if hypersensitivity to benzodiazepines is present or if there is severe respiratory or hepatic dysfunction or drug or alcohol dependence. Because clonazepam can cross the placenta to reach and accumulate in the unborn child, the drug should not be administered during pregnancy. In the event of an overdose, mental disabilities or malformations are conceivable in the child. The drug should also not be used during breastfeeding, as it can pass into the mother’s milk. This may cause breathing problems for the child. Interactions between clonazepam and other drugs that affect the brain are also possible. These may be sedatives, sleeping pills, anesthetics, painkillers, psychotropic drugs or H1 antihistamines. These have a reinforcing effect on the drug. The same applies to the consumption of alcohol.
