Klonopin (5-(2-chlorophenyl)-1, 3-dihydro7-nitro-2H-1, 4-benzodiazepin-2-one), known generically as clonazepam, is manufactured and distributed by Roche. It is a benzodiazepine drug used primarily as an anti-anxiety or anxiolytic and is in the same family of drugs as Valium (diazepam) and Xanax (alprazolam). It is considered by the DEA, under the Controlled Substances Act, to be a Schedule IV drug with abuse and addiction potential. It is available by prescription for legitimate medical uses such as an anti-epileptic for petit mal, akinetic and myoclonus seizure activity; a muscle relaxant and for treatment of severe and debilitating worry, anxiety, fear and panic.
Methods of Use
Klonopin is primarily used orally as tablets of varying dosage and swallowed whole. It is also available as an orally disintegrating tablet or wafer.
The use of Klonopin as prescribed may cause side-effects that indicate a need to seek medical advice. Some of these are:
• feelings of fatigue
• muscle weakness
• blurred vision
• poor concentration
• memory problems
• loss of appetite
• stomach distress
• loss of libido
Klonopin is known to have induced severe and adverse effects in some individuals who take the medication as prescribed. These adverse effects require immediate, emergency medical attention. CNS suppression is considered a life-endangering effect and has been experienced by some. Some of the other serious side-effects of Klonopin use that have been documented are:
• respiratory suppression
• psychotic thinking
• disorganized behavior
• involuntary eye movements
• difficult urination
The use of Klonopin has caused some paradoxical reactions in some individuals. These are medication-induced effects that are typically opposite of the effects for which the medication is used. Some of the paradoxical effects of Klonopin can be:
• vivid dreaming
• severe anxiety
Potentiation of Klonopin
The effects and strength of a Klonopin dosage may be potentiated, or dramatically increased, when used in combination with other medications and substances such as alcohol, sedatives, hypnotics, opioids, other benzodiazepines, antipsychotics, anti-convulsants, MAO’s and some anti-depressants.
The use of Klonopin in combination with medications and substances that potentiate its effects may result in serious and severe symptoms and conditions including CNS, cardiac and respiratory crisis, coma and even death.
The symptoms of Klonopin overdose include CNS suppression, shallow breathing, confusion, muscle weakness, drowsiness, fainting, slowed reflexes, slowed responsiveness and coma. Such symptoms require immediate medical attention.
Treatment for Klonopin overdose may include the use of an antidote for benzodiazepine overdose and/or emptying the contents of the stomach through emergency medical procedures. Monitoring of blood pressure, heart rate and respiration to prevent further crisis are standard protocol. Contraindications of Klonopin Use
Some contraindications of Klonopin use include those individuals with liver disease, glaucoma, alcoholism and other substance dependencies.
Klonopin has significant abuse potential and is considered a common medication of abuse. Abuse of Klonopin can result in:
• feeling of sedation
• feeling of intoxication
• slurred speech
• impaired thinking
• impaired motor skills
• impaired judgment
• abnormal eye movements
• shallow breathing
• mood dysregulation
As a benzodiazepine, Klonopin is categorized by the DSM-IV-TR (Diagnostic and Statistical Manual Of Mental Disorders) as an anxiolytic. It is grouped along with Substance Disorders involving the use of sedatives and hypnotics such as barbiturates, sleeping medications and other anti-anxiety medications.
Medical diagnoses given that involve the use of Klonopin include:
• Anxiolytic Intoxication
• Anxiolytic Abuse
• Anxiolytic Dependence
• Anxiolytic Withdrawal
• Anxiolytic Intoxication Delirium
• Anxiolytic Withdrawal Delirium
• Anxiolytic-Induced Persisting Dementia
• Anxiolytic-Induced Persisting Amnestic Disorder
• Anxiolytic-Induced Psychotic Disorder
• Anxiolytic-Induced Psychotic Disorder, with Hallucinations
• Anxiolytic-Induced Mood Disorder
• Anxiolytic-Induced Anxiety Disorder
• Anxiolytic-Induced Sexual Dysfunction
• Anxiolytic-Induced Sleep Disorder
• Anxiolytic-Related Disorder Not Otherwise Specified or Atypical Anxiolytic-Related Disorder
The medical diagnoses given for any of these Klonopin use disorders may be written using the words benzodiazepine, Klonopin or clonazepam instead of anxiolytic.
Klonopin Abuse, Dependence and Withdrawal
Klonopin can cause physical and psychological dependence. The physical dependence potential of Klonopin requires that use be titrated toward cessation to manage withdrawal symptoms and safety after high dose usage or prolonged use. Medical supervision for withdrawal from Klonopin is strongly indicated due to the possibility of severe symptoms and complications that can be experienced during withdrawal. Medical supervision for withdrawal and detoxification manages a complete graduated cessation of use while monitoring and attenuating physical responses to withdrawal.
Some individuals will experience psychiatric symptoms at cessation, including suicidality and psychosis, which are clinically significant enough to warrant observation and support. Some will experience a Substance-Induced Mood Disorder or Substance-Induced Psychotic Disorder with onset occurring after use has stopped. These Substance-Induced Disorders may require supervision and treatment in a structured therapeutic environment to manage severe depression, mania, suicidality, aggression or disorientation.
Symptoms of Acute Klonopin Withdrawal
Abrupt cessation of Klonopin can cause:
• muscle cramps
• lowered blood pressure
• severe anxiety
• suicidal ideation
• muscle weakness
Treatment of Klonopin Dependence
Treatment for Klonopin abuse and dependence begins with medical supervision during withdrawal and detoxification. Individuals in treatment for Klonopin use disorders are typically treated during withdrawal and detoxification with a gradual decline in dosage until completely free of Klonopin. Some individuals who have used Klonopin for an extended period of time may have dosages tapered over 6-8 weeks. This can occur in outpatient settings, but some may require inpatient treatment for intensive support and management of related physical and/or psychiatric symptomology.
Stages of treatment that follow detoxification from Klonopin are those typically used for treatment of other Substance Disorders. Treatment modalities can include individual and group counseling, family counseling, psychiatric services, self-help groups such as 12 Step meetings, nutritional counseling, exercise routines, relaxation techniques, stress management, behavioral techniques and psychoeducation.