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'''Clonazepam''', sold under the brand name '''Klonopin''' among others, is a [[:Category:Benzodiazepines|benzodiazepine]] tranquiliser. It binds to GABA<sub>A</sub> receptors and increases the effect of the neurotransmitter [[GABA]].<ref name="Riss-2008" /> ==Uses == It is used to treat seizures,<ref name="medlineclonazepam">[https://medlineplus.gov/druginfo/meds/a682279.html#why MedlinePlus β Clonazepam]</ref><ref name="nhsclonazepam" /> [[anxiety]]</ref><ref name="nami">{{Cite web | url = https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Clonazepam-(Klonopin) | website = NAMI | date = 2021-03-23 | title = Clonazepam}}</ref> and [[panic disorder]]s,<ref name="medlineclonazepam" /><ref name="drugsclonazepam">{{Cite web | url = https://www.drugs.com/monograph/clonazepam.html|website =Drugs.com | date = 2021-03-23 | title = Drugs.com β Clonazepam}}</ref> movement problems such as [[akathisia]],<ref name="drugsclonazepam" /> [[bruxism]]<ref name="Huynh">{{Citation | last1 = Huynh | first1 = NT. | last2 = RomprΓ© | first2 = PH. | last3 = Montplaisir | first3 = JY. | last4 = Manzini | first4 = C. | last5 = Okura | first5 = K. | last6 = Lavigne | first6 = GJ. | title = Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size. | journal = Int J Prosthodont | volume = 19 | issue = 5 | pages = 435β41 | pmid = 17323720 | year = 2006 }}</ref> or [[restless legs syndrome]],<ref name="trenkwalder">{{Citation | last1 = Trenkwalder | first1 = C. | last2 = Hening | first2 = WA. | last3 = Montagna | first3 = P. | last4 = Oertel | first4 = WH. | last5 = Allen | first5 = RP. | last6 = Walters | first6 = AS. | last7 = Costa | first7 = J. | last8 = Stiasny-Kolster | first8 = K. | last9 = Sampaio | first9 = C. | title = Treatment of restless legs syndrome: an evidence-based review and implications for clinical practice | journal = Mov Disord | volume = 23 | issue = 16 | pages = 2267β302 | date = Dec 2008 | doi = 10.1002/mds.22254 | url = http://www.movementdisorders.org/publications/ebm_reviews/treatmentofrls.pdf | format = PDF | pmid = 18925578 }}</ref> muscle problems<ref name="nhsclonazepam">[http://www.evidence.nhs.uk/formulary/bnf/current/4-central-nervous-system/48-antiepileptic-drugs/481-control-of-the-epilepsies/benzodiazepines/clonazepam British National Formulary β Clonazepam]</ref> and some sleep disorders.<ref name="Ferini-Strambi">{{Citation | last1 = Ferini-Strambi | first1 = L. | last2 = Zucconi | first2 = M. | title = REM sleep behavior disorder | journal = Clin Neurophysiol | volume = 111 | issue =Suppl 2 | pages = S136β40 | date = Sep 2000 | pmid = 10996567 | doi = 10.1016/S1388-2457(00)00414-4}}</ref><ref name="schenck">{{Citation | last1 = Schenck | first1 = CH. | last2 = Arnulf | first2 = I. | last3 = Mahowald | first3 = MW. | title = Sleep and Sex: What Can Go Wrong? A Review of the Literature on Sleep Related Disorders and Abnormal Sexual Behaviors and Experiences | journal = Sleep | volume = 30 | issue = 6 | pages = 683β702 | date = Jun 2007 | doi = | pmid = 17580590 }}</ref> Several [[ME/CFS]] specialists employ clonazepam in their treatment protocols for a variety of uses.<ref name="haavisto2011">{{citation | last = Haavisto|first = Maija | date = 2011 | title = [[Reviving the Broken Marionette]]|url= |location= | publisher = Lulu.com | pages = 28-29|isbn=978-1409203353}}</ref> It is usually taken orally and begins having an effect within an hour, lasting between six and twelve hours.<ref name="Coop2007">{{citation | last1 = Cooper | first1 = Grant | title = Therapeutic uses of botulinum toxin | date = 2007 | publisher = Humana Press|location=Totowa, N.J.|isbn=9781597452472 | page = 214 | url = https://books.google.ca/books?id=UIUhCmMtqq8C&pg=PA214}}</ref> It can cause dependence or addiction, and tolerance in long-term use, and withdrawal symptoms are common.<ref name=AHFS2015>{{citation | title=Clonazepam | url = http://www.drugs.com/monograph/clonazepam.html | publisher = The American Society of Health-System Pharmacists|access-date=2016-12-13}}</ref> Dependence occurs in one-third of people who take clonazepam for longer than four weeks.<ref name="Riss-2008">{{Citation | last1 = Riss | first1 = J. | last2 = Cloyd | first2 = J. | last3 = Gates | first3 = J. | last4 = Collins | first4 = S. | title = Benzodiazepines in epilepsy: pharmacology and pharmacokinetics. | url = http://www3.interscience.wiley.com/cgi-bin/fulltext/120119477/PDFSTART | format = PDF | journal = Acta Neurol Scand | volume = 118 | issue = 2 | pages = 69β86 | date = August 2008 | doi = 10.1111/j.1600-0404.2008.01004.x | pmid = 18384456 }}</ref> ==ME/CFS == Clonazepam is a medication suggestion in the [[Canadian Consensus Criteria]] for ME/CFS to help with [[insomnia]], as a muscle relaxant, and for anxiety.<ref name="canadianconsensus-CCC" />{{Rp|52}} Low dose benzodiazepines such as clonazepam are suggested for crashes caused by [[sensory overload]] (too much sensory input) according to the [[International Consensus Criteria]].<ref name="ICC2011primer">{{citation | last = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | author-link2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | author-link3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | author-link4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | author-link20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | author-link21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | author-link22 = John McLaren-Howard | last23 = Mena | first23 = I | author-link23 = Ismael Mena | last24 = Miwa | first24 = K | author-link24 = Kunihisa Miwa | last25 = Murovska | first25 = M | author-link25= Modra Murovska | last26 = Stevens | first26 = SR | author-link26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012 | isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref> ==Risks and safety == Clonazepam is highly addictive.<ref name="canadianconsensus-CCC" />{{Rp|52}} Side effects are the same as for other benzodiazepines, and similar to [[central nervous system]] depressant drugs; including drowsiness, lack of coordination and ataxia. Clonazepam and [[doxepin]] are often used together to improve sleep duration, and work within 1-2hrs.<ref name="canadianconsensus-CCC">{{Citation | last = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | author-link2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | author-link3 = Kenny De Meirleir | last4 =Peterson | first4 = Daniel L. | author-link4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 =Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande| title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02| url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf}}</ref>{{Rp|52}} ==Clinicans== *[[Paul Cheney]] *[[Charles Lapp]] *[[David Bell]] ==Costs and availability== Clonazepam is available in most countries with a prescription. It is available as a generic medication and is generally very inexpensive. Availability may be very restricted due to the risk of addiction and substance misuse. ==Dosage == For ME/CFS patients a dose of 0.5-2.0 mg per night at bedtime is recommended.<ref name="canadianconsensus-CCC" />{{Rp|52}} ==See also == *[[Sensory overload]] *[[Anxiety]] *[[Lorazepam]] (Ativan) ==Learn more== *[https://www.drugs.com Clonazepam] - drugs.com *[https://www.prohealth.com/library/dr-paul-cheney-discusses-the-benefits-of-klonopin-19834 Dr. Paul Cheney Discusses The Benefits Of Klonopin] *[https://phoenixrising.me/treating-cfs-chronic-fatigue-syndrome-me/the-first-symptom-sleep/treating-chronic-fatigue-syndrome-mecfs-and-fibromyalgia-a-prescription-for-sleep/klonopin Klonopin (Clonazepam)] - [[David Bell]] *[https://phoenixrising.me/archives/12200 The Best Drug for ME/CFS? The Other Side of Klonopin: A Patient's Story and A Survey] ==References== {{Reflist}} [[Category:Potential treatments]] [[Category:Benzodiazepines]][[Category:Anticonvulsants]] [[Category:Muscle relaxants]] [[Category:Sleep aids and hypnotics]]
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