Clonazepam

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Clonazepam, sold under the brand name Klonopin among others, is a benzodiazepine tranquiliser. It binds to GABAA receptors and increases the effect of the neurotransmitter GABA.[1]

Uses[edit | edit source]

It is used to treat seizures,[2][3] anxiety</ref>[4] and panic disorders,[2][5] movement problems such as akathisia,[5] bruxism[6] or restless legs syndrome,[7] muscle problems[3] and some sleep disorders.[8][9] Several ME/CFS specialists employ clonazepam in their treatment protocols for a variety of uses.[10]

It is usually taken orally and begins having an effect within an hour, lasting between six and twelve hours.[11] It can cause dependence or addiction, and tolerance in long-term use, and withdrawal symptoms are common.[12] Dependence occurs in one-third of people who take clonazepam for longer than four weeks.[1]

ME/CFS[edit | edit source]

Clonazepam is a medication suggestion in the Canadian Consensus Criteria for ME/CFS to help with insomnia, as a muscle relaxant, and for anxiety.[13]: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.[14]

Risks and safety[edit | edit source]

Clonazepam is highly addictive.[13]: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.[13]:52

Clinicans[edit | edit source]

Costs and availability[edit | edit source]

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[edit | edit source]

For ME/CFS patients a dose of 0.5-2.0 mg per night at bedtime is recommended.[13]:52

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. ↑ 1.0 1.1 Riss, J.; Cloyd, J.; Gates, J.; Collins, S. (August 2008), "Benzodiazepines in epilepsy: pharmacology and pharmacokinetics." (PDF), Acta Neurol Scand, 118 (2): 69–86, doi:10.1111/j.1600-0404.2008.01004.x, PMID 18384456
  2. ↑ 2.0 2.1 MedlinePlus – Clonazepam
  3. ↑ 3.0 3.1 British National Formulary – Clonazepam
  4. ↑ "Clonazepam". NAMI. March 23, 2021.
  5. ↑ 5.0 5.1 "Drugs.com – Clonazepam". Drugs.com. March 23, 2021.
  6. ↑ Huynh, NT.; Rompré, PH.; Montplaisir, JY.; Manzini, C.; Okura, K.; Lavigne, GJ. (2006), "Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size.", Int J Prosthodont, 19 (5): 435–41, PMID 17323720
  7. ↑ Trenkwalder, C.; Hening, WA.; Montagna, P.; Oertel, WH.; Allen, RP.; Walters, AS.; Costa, J.; Stiasny-Kolster, K.; Sampaio, C. (December 2008), "Treatment of restless legs syndrome: an evidence-based review and implications for clinical practice" (PDF), Mov Disord, 23 (16): 2267–302, doi:10.1002/mds.22254, PMID 18925578
  8. ↑ Ferini-Strambi, L.; Zucconi, M. (September 2000), "REM sleep behavior disorder", Clin Neurophysiol, 111 (Suppl 2): S136–40, doi:10.1016/S1388-2457(00)00414-4, PMID 10996567
  9. ↑ Schenck, CH.; Arnulf, I.; Mahowald, MW. (June 2007), "Sleep and Sex: What Can Go Wrong? A Review of the Literature on Sleep Related Disorders and Abnormal Sexual Behaviors and Experiences", Sleep, 30 (6): 683–702, PMID 17580590
  10. ↑ Haavisto, Maija (2011), Reviving the Broken Marionette, Lulu.com, pp. 28–29, ISBN 978-1409203353
  11. ↑ Cooper, Grant (2007), Therapeutic uses of botulinum toxin, Totowa, N.J.: Humana Press, p. 214, ISBN 9781597452472
  12. ↑ Clonazepam, The American Society of Health-System Pharmacists, retrieved December 13, 2016
  13. ↑ 13.0 13.1 13.2 13.3 Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, AC Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF), Journal of Chronic Fatigue Syndrome, 11 (2): 7–115, doi:10.1300/J092v11n01_02
  14. ↑ Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6

flare-up A symptoms flare in ME/CFS is a temporary increase in symptoms, alternatively known as experiencing post-exertional malaise. May be referred to as a "crash" or "collapse".

adverse reaction Any unintended or unwanted response to a treatment, whether in a clinical trial or licensed treatment. May be minor or serious.

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