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Among different benzodiazepines, Klonopin or Clonazepam is one of the most well-known anticonvulsant agents. It also has a slight calming, anxiolytic and hypnotic effect but the main indication for its utilization is epilepsy for both adults and children. Let’s learn more about its utilization and special features.
The mechanism of action and effects
Clonazepam is an active ingredient of Klonopin and belongs to benzodiazepine derivatives. This medicine possesses a strong and long-lasting anticonvulsant effect. In addition, mild anxiolytic, sedative, hypnotic and muscle relaxant effects are also observed during its utilization.
Indications for use include:
- epilepsy in children (typical and atypical, generalized tonic-clonic seizures);
- epilepsy in adults (focal seizures);
- psychomotor excitement due to reactive psychoses;
- various phobias accompanied by strong fear, including agoraphobia (only for adults).
The mechanism of its action is the same as for other benzodiazepines, namely an active ingredient interacts with GABA receptors and promotes the inhibition of neurons, the cells of the brain. This leads to all the above-mentioned effects. The most pronounced for this compound is anticonvulsant, still other types of action are also present.
Dosage and administration
The usual dosage form is tablets of 0.5 mg, 1 mg and 2 mg. They often have different colors to make the intake easier and prevent overdose.
The doctor must determine the exact dose and duration of therapy individually for the patient and his condition. Treatment usually starts with low doses, which are gradually increasing until obtaining a therapeutic effect.
For instance, adults with epilepsy may get the initial dose of 1 mg/day, divided into 3 doses. It is increased by 0.5-1 mg every 3 days until the effect is optimal. Then, the maintenance dose is set (usually 4-8 mg/day in 3-4 doses). The maximum daily dose is 20 mg.
For elderly patients, the starting dose must not exceed 0.5 mg to avoid side effects. Then, it can be also increased step by step until the optimal level is reached.
The initial dose for children depends on the age and starts from 0.25 mg/day for one-year-old infants. The maximum daily dose is 0.2 mg/kg of body weight.
Contraindications and side effects
Klonopin must not be prescribed in the following situations:
- hypersensitivity and allergic reactions to benzodiazepines;
- breathing disorders of central origin and severe respiratory failure;
- sleep apnea syndrome;
- closed-angle glaucoma;
- severe liver or kidney failure;
- alcohol or drug addiction.
Clonazepam is prohibited during pregnancy and breastfeeding due to possible harmful effects on the fetus. They were revealed in investigations on animals. Therefore, this medicine is not practiced in this case.
The patient, who gets this type of treatment, should avoid driving or operating machines and vehicles, especially during the first period of the treatment due to the possible influence on concentration. If there are no adverse effects, then this restriction may be canceled.
Side effects are not very common but may include:
- Psychiatric disorders, such as amnesia, aggressiveness, nervousness, irritability, agitation, anxiety, sleep disturbances and mental disorders.
- Nervous system issues like dizziness, lightheadedness, drowsiness, fatigue, coordination problems, muscle weakness, decreased concentration and memory, headaches, confusion and disorientation.
- Vision disorders.
- Cardiovascular system issues, including cardiac failure and blood formula changes.
- Respiratory system depression or inflammation processes.
- Digestive tract disorders like increased saliva production, decreased appetite, abdominal pain, constipation, nausea and vomiting.
- Skin itching, temporary hair loss.
- Muscle weakness and pain.
- Urinary incontinence or frequent urination.
- Erectile dysfunction and loss of libido.
- Allergic reactions and rarely anaphylaxis.
In the physical dependence was developed, the sudden stop of treatment will be accompanied by withdrawal symptoms. Moreover, abrupt stop of intake may provoke even stronger seizures than before. That is why this process must be strictly controlled by the doctor, who decreases the dose and follows the process.
Furthermore, an increased risk of falls and fractures has been reported in elderly patients while using benzodiazepines, including Klonopin. Thus, their treatment should also be carefully controlled and monitored.
Conclusions
Klonopin or Clonazepam is an effective agent for the treatment of epilepsies of various origins for both adults and children. It is possible to select the individual dose according to the needs of the patient and reach an optimal effect without negative adverse consequences. Still, one should remember that this medicine is very powerful and the process of treatment with it must be carefully controlled and followed by the specialist.