Clonazepam: Uses, Dosing, Side Effects & Contraindications

Colonazepam is an anxiolytic and anticonvulsant medication that is prescribed for the treatment of epileptic seizures, anxiety disorder, panic syndrome and mood disorders, like depression or bipolar. It works by mildly inhibiting the nervous system and inducing a tranquilizing, sedative and relaxing effect. 

This medication can be obtained at the pharmacy with a prescription in pill form, drops or sublingual form. 

Clonazepam should only be used as directed by a doctor and should be avoided by patients with a history of serious liver or respiratory issues.

Common uses

Clonazepam is prescribed for:

  • Epileptic seizures 
  • West syndrome, which are epileptic seizures in childhood 
  • Panic syndrome, with or without an open space phobia
  • Social phobia 
  • Bipolar disorder
  • Mania
  • Major depression
  • Restless leg syndrome
  • Vertigo and related symptoms, like loss of balance, nausea, vomiting, falls, ringing ears or auditory disturbances 
  • Burning mouth syndrome 

Clonazepam can also be indicated for the treatment of akathysia, which is an extreme restlessness that may be provoked by psychiatric medications. 

How to take and dosing

Clonazepam should be taken orally at the times indicated by the doctor. Doses for adults and children should be prescribed by a doctor, who will adjust dosing for each individual case based on the illness and age. 

Generally, the initial dose for a doctor varies between 0.25 mg and 1.5 mg per day. This dose can be gradually increased until the underlying issue is well-managed. For children, dosing is calculated using age and weight. 

The way clonazepam is taken varies depending on its form: 

  • Oral clonazepam pills: Take the pill orally with a cup of water 
  • Sublingual clonazepam: Place the pill beneath your tongue and allow it to dissolve in your saliva, without chewing, until it has absorbed completely 
  • Clonazpem drops: These drops should be diluted in water before taking them, Never place the drops directly in your mouth. 

If you forget to take a dose at the right time, take it as soon as you remember. However you should skip this dose altogether if it is almost time for your next dose. Doubling a dose to compensate for a forgotten one is not advised. 

The duration of treatment with clonazepam varies depending on the medical assessment, It is important to continue treatment, and to not stop it on your own, as this medication can cause dependency. 

To discontinue treatment, clonazepam doses should be reduced gradually under a doctor’s monitoring. This help to prevent symptoms like psychosis, tremors, increased seats, agitation, extreme anxiety, fatigue, mental confusion, irritability or seizures. 

Possible side effects

The most common side effects that can emerge with clonazepam treatment include drowsiness, dizziness, fatigue, depression, memory problems or difficulty coordinating movements or walking. 

In addition, clonazepam can cause a physical dependency and can lead to sudden consecutive seizures if used excessively and incorrectly. 

Clonazepam can cause severe allergic reactions that require immediate medical attention. Therefore, you should stop treatment and attend the closest emergency room if you notice symptoms like difficulty breathing, a closing throat, or swelling in th mouth, tongue or face. 

In addition, you should communicate any mood changes, depression, anxiety, panic attacks, difficulty sleeping, impulsivity, irritation, agitation, aggression or suicidal thoughts to your doctor. 

Does clonazepam cause weight gain or loss? 

Clonazepam can cause changes to weight as a side effect. Because clonazepam causes drowsiness, some people may notice less of an urge to engage in physical activity, meaning less calories being burned and more weight gain. 

In other cases, clonazepam can lead to weight loss due to its side effect of appetite loss. 

Nonetheless, it is important to highlight that clonazepam is not advised to achieve weight gain or weight loss goals. Due to its side effects, patients should be carefully monitored by their doctor. 

Contraindications for use

Clonazepam should not be used by people who have angle-closure glaucoma, severe respiratory failure or liver disease. This medication can increase the risk for hepatic encephalopathy. 

This medication should also not be used by patients with a an allergy to clonazepam or to other anxiolytics like diazepam, alprazolam or lorazepam. 

Clonazepam should not be used during pregnancy or breastfeed. These populations of women should be assessed by a doctor on a case-by-case basis, as clonazepam use can be risky for the baby and cause dependency. 

When taking clonazepam, you should avoid activities like driving, using heavy machinery or engaging in dangerous activities, due to its side effects like drowsiness or dizziness. Alcohol may increase the effects of clonazepam and should therefore be avoided during treatment.