Jan 16, 2015, 01:10 PM
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Member Since: Oct 2012
Location: U.S.
Posts: 2,569
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Here are some links:
MedlinePlus - Search Results for: klonopin side effects
Klonopin oral Reviews and User Ratings: Effectiveness, Ease of Use, and Satisfaction
KLONOPIN: Side effects, ratings, and patient comments (pay extra attention to the duration and dosage column)- Anita may have used a .25 mg dose for a day or week. While Johnny Boy may have been on 2mg for 2yrs.
Side Effects of Klonopin (Clonazepam) Drug Center - RxList
Quote:
Common[edit]
Drowsiness[32]
Motor impairment
Less common[edit]
Confusion[8]
Irritability and aggression[33]
Psychomotor agitation[34]
Lack of motivation[35]
Loss of libido
Impaired motor function[vague]
Impaired coordination
Impaired balance
Dizziness
Cognitive impairments[vague][36]
Hallucinations[37]
Short-term memory loss[38]
Anterograde amnesia (common with higher doses)[39]
Some users report hangover-like symptoms of drowsiness, headaches, sluggishness, and irritability upon waking up if the medication was taken before sleep. This is likely the result of the medication's long half-life, which continues to affect the user after waking up.[citation needed]
The "hangover effect" some experience not only results from clonazepam's considerably long half-life, but also, like many other benzodiazepines, when taken as a sleep aid, clonazepam's disruption or interference with the brain's delta waves. Delta waves signify the brain's slowest waves (~4 Hz) and occur during Stage 4 sleep, which designates humans' deepest sleep state (when the muscles are the most relaxed; breathing slows and becomes shallow), and the stage right before R.E.M. sleep and dreaming (Stage 5). Therefore, upon waking, this disruption of Stage 4 delta wave sleep causes a deficit in adequate brain/body rest or "recharge".[citation needed]
[40][41] While benzodiazepines induce sleep, they tend to reduce the quality of sleep by suppressing or disrupting REM sleep.[42] After regular use, rebound insomnia may occur when discontinuing clonazepam.[43]
Benzodiazepines may cause or worsen depression.[8]
Occasional[edit]
Dysphoria[44]
Thrombocytopenia[45]
Induction of seizures[46][47] or increased frequency of seizures[48]
Personality changes[49]
Behavioural disturbances[50]
Ataxia[8]
Euphoria (possibly attributed to its anxiolytic properties)[citation needed]
Rare[edit]
Psychosis[51]
Incontinence[52][53][54]
Liver damage[55]
Paradoxical behavioural disinhibition[8][56] (most frequently in children, the elderly, and in persons with developmental disabilities)
Rage
Excitement
Impulsivity
Long term effects[edit]
The long term effects of clonazepam can include depression,[8] disinhibition, and sexual dysfunction.[57]
Withdrawal-related[edit]
Anxiety, irritability, insomnia, tremors
Potential to exacerbate existing panic disorder upon discontinuation
Seizures[58] similar to delirium tremens (with long-term use of excessive doses)
Benzodiazepines such as clonazepam can be very effective in controlling status epilepticus, but, when used for longer periods of time, some potentially serious side-effects may develop, such as interference with cognitive functions and behavior.[59] Many individuals treated on a long-term basis develop a form of dependence known as "low-dose dependence,"[according to whom?] as was shown in one double-blind, placebo-controlled study of 34 therapeutic low-dose benzodiazepine users. Physiological dependence was demonstrated by flumazenil-precipitated withdrawal.[60] Use of alcohol or other CNS depressants while taking clonazepam greatly intensifies the effects (and side-effects) of the drug.
Tolerance and withdrawal[edit]
Main article: Benzodiazepine withdrawal syndrome
Like all benzodiazepines, clonazepam is a benzodiazepine receptor agonist.[61][62] One third of individuals treated with benzodiazepines for longer than four weeks develop a dependence on the drug and experience a withdrawal syndrome upon dose reduction. High dosage and long-term use increases the risk and severity of dependence and withdrawal symptoms. Withdrawal seizures and psychosis can occur in severe cases of withdrawal, and anxiety and insomnia can occur in less severe cases of withdrawal. Gradual reduction in dosage reduces the severity of the benzodiazepine withdrawal syndrome. Due to the risks of tolerance and withdrawal seizures, clonazepam is generally not recommended for the long-term management of epilepsies. Increasing the dose can overcome the effects of tolerance, but tolerance to the higher dose may occur and adverse effects may intensify. The mechanism of tolerance includes receptor desensitisation, down regulation, receptor decoupling, and alterations in subunit composition and in gene transcription coding.[8]
Tolerance[edit]
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This section requires expansion. Relevant discussion may be found on the talk page. (February 2014)
Tolerance to the anticonvulsant effects of clonazepam occurs in both animals and humans. In humans, tolerance to the anticonvulsant effects of clonazepam occurs frequently.[63][64] Chronic use of benzodiazepines can lead to the development of tolerance with a decrease of benzodiazepine binding sites. The degree of tolerance is more pronounced with clonazepam than with chlordiazepoxide.[65] In general, short-term therapy is more effective than long-term therapy with clonazepam for the treatment of epilepsy.[66] Many studies have found that tolerance develops to the anticonvulsant properties of clonazepam with chronic use, which limits its long-term effectiveness as an anticonvulsant.[67]
Withdrawal[edit]
Abrupt or over-rapid withdrawal from clonazepam may result in the development of the benzodiazepine withdrawal syndrome, causing psychosis characterised by dysphoric manifestations, irritability, aggressiveness, anxiety, and hallucinations.[68][69][70] Sudden withdrawal may also induce the potentially life-threatening condition, status epilepticus. Anti-epileptic drugs, benzodiazepines such as clonazepam in particular, should be reduced in dose slowly and gradually when discontinuing the drug to mitigate withdrawal effects.[49] Carbamazepine has been tested in the treatment of clonazepam withdrawal and was found to be ineffective in preventing clonazepam withdrawal-induced status epilepticus from occurring.[71]
Overdose[edit]
Main article: Benzodiazepine overdose
An individual who has exceeded their recommended dosage of clonazepam may display one or more of the following symptoms:
Somnolence (difficulty staying awake)
Mental confusion
Nausea
Impaired motor functions
Impaired reflexes
Impaired coordination
Impaired balance
Dizziness
Respiratory depression
Hypotension
Coma
Coma can be cyclic, with the individual alternating from a comatose state to a hyper-alert state of consciousness, which occurred in a 4-year-old boy who suffered an overdose of clonazepam.[72] The combination of clonazepam and certain barbiturates, e.g. amobarbital, at prescribed doses has resulted in a synergistic potentiation of the effects of each drug, leading to serious respiratory depression.[73]
Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, and fainting.[74]
Although an overdose of clonazepam is a serious medical concern, there have been no known instances of death from such an overdose. The LD50 for both mice and rats is greater than 2,000 mg per kilogram of body weight.[75]
Detection in biological fluids[edit]
Clonazepam and 7-aminoclonazepam may be quantified in plasma, serum or whole blood in order to monitor compliance in those receiving the drug therapeutically. Results from such tests can be used to confirm the diagnosis in potential poisoning victims or to assist in the forensic investigation in a case of fatal overdosage. Both the parent drug and 7-aminoclonazepam are unstable in biofluids, and therefore specimens should be preserved with sodium fluoride, stored at the lowest possible temperature and analyzed quickly to minimize losses.[76]
Special precautions[edit]
The elderly metabolise benzodiazepines more slowly than younger individuals and are also more sensitive to the effects of benzodiazepines, even at similar blood plasma levels. Doses for the elderly are recommended to be about half of that given to younger adults and are to be administered for no longer than 2 weeks. Long-acting benzodiazepines such as clonazepam are not generally recommended for the elderly due the risk of drug accumulation.[8]
The elderly are especially susceptible to increased risk of harm from motor impairments and drug accumulation side effects. Benzodiazepines also require special precaution if used by individuals that may be pregnant, alcohol- or drug-dependent, or may have comorbid psychiatric disorders.[77] Clonazepam is generally not recommended for use in elderly people for insomnia due to its high potency relative to other benzodiazepines.[78]
Clonazepam is not recommended for use in those under 18. Use in very young children may be especially hazardous. Of anticonvulsant drugs, behavioural disturbances occur most frequently with clonazepam and phenobarbital.[77][79]
Doses higher than 0.5–1 mg per day are associated with significant sedation.[80]
Clonazepam may aggravate hepatic porphyria.[81][82]
Clonazepam is not recommended for patients with chronic schizophrenia. A 1982 double-blinded, placebo-controlled study found clonazepam increases violent behavior in individuals with chronic schizophrenia.[83]
Interactions[edit]
Clonazepam decreases the levels of carbamazepine,[84][85] and, likewise, clonazepam's level is reduced by carbamazepine. Azole antifungals, such as ketoconazole, may inhibit the metabolism of clonazepam.[8] Clonazepam may affect levels of phenytoin (diphenylhydantoin).[84][86][87][88] In turn, Phenytoin may lower clonazepam plasma levels by increasing the speed of clonazepam clearance by approximately 50% and decreasing its half-life by 31%.[89] Clonazepam increases the levels of primidone[87] and phenobarbital.[90]
Combined use of clonazepam with certain antidepressants, antiepileptics, such as phenobarbital, phenytoin and carbamazepine, sedative antihistamines, opiates, antipsychotics, nonbenzodiazepine hypnotics like zolpidem and alcohol may result in enhanced sedative effects.[8]
Warnings[edit]
Clonazepam, like other benzodiazepines, will impair one's ability to drive or operate machinery. The central nervous system-depressing effects of the drug can be intensified by alcohol consumption, and therefore alcohol should be avoided while taking this medication. Benzodiazepines have been shown to cause both psychological and physical dependence. Patients physically dependent on clonazepam should be slowly titrated off under the supervision of a qualified healthcare professional to reduce the intensity of withdrawal or rebound symptoms.
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Clonazepam - Wikipedia, the free encyclopedia
You should read that whole wiki. link if you can, a lot of good information about the med. and tons of references.
Keep in mind that many resources list almost every reaction people have ever had but heed the serious ones more carefully.
Also, discuss the medication with your healthcare team and ask any questions that may arise.
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