Benzodiazepines Development
Benzodiazepines, such as clonazepam, are prescription sedative medications. Clonazepam was patented in 1960. In 1975, it went on sale in the United States, by the pharmaceutical company Roche, under the brand name Klonopin. 4 It is now also available as a generic medication.
Clonazepam has consistently been a top selling drug since it went on sale in 1975. In 1997, clonazepam was approved in the United States for epilepsy treatment. More than 20 million prescriptions are filled each year for the drug. 5
Prior Medical Uses
Historically, benzodiazepine drugs have been beneficially used to treat anxiety disorders, the physical symptoms associated with generalized anxiety disorder (GAD), panic disorder, and obsessive compulsive disorder (OCD) as well as epilepsy and neurological illnesses related to epilepsy. The medications have also enjoyed a long history of use in pre-surgical settings and for dental sedation. 2
How It Works
The exact way clonazepam works is unknown, but research theorizes that its antiseizure and antipanic properties are related to the drug’s ability to boost gamma aminobutyric acid (GABA) activity, the major inhibitory neurotransmitter in the CNS (central nervous system). 6
Common Misconceptions About Clonazepam and Klonopin
Clonazepam carries little risk since it’s a prescribed medication
Many people believe that when a drug is prescribed, there are no risks. While this is mostly true when a drug is taken as prescribed, misuse of prescribed medications, including clonazepam, can be harmful and even deadly. Also, a tolerance for clonazepam can develop in just a few weeks despite being taken as prescribed.
You can’t overdose on clonazepam
In 2018, NIDA reported that more than a third of overdoses involving opioids also involved benzodiazepines. 7 Also, mixing clonazepam (or any other benzodiazepine) with alcohol or other depressant medications increases the risk for an adverse reaction with a potentially fatal outcome.
You can’t misuse prescription medications
Misuse of prescription drugs is a serious public health problem in our nation. In 2017, the National Institute on Drug Abuse (NIDA) reported that about 18 million people (which is approximately 6% of people 12 years of age and older) have misused such medications at least once in the past year. 8
Why Is Clonazepam Used?
The two most common uses of clonazepam are for control of seizures and panic attacks.
Clonazepam is useful in the treatment of seizure disorders, such as: 6
- absence seizures (petit mal)
- Lennox-Gastaut syndrome (petit mal variant)
- myoclonic seizures
- akinetic seizures
Clonazepam is also useful in treating panic disorders with or without agoraphobia. People with a panic disorder:
- have unexpected panic attacks
- worry about future panic attacks
- fret over the consequences of the attacks
- significantly change their behavior related to panic attacks
What Does Clonazepam or Klonopin Do to the Body?
Despite the effectiveness of clonazepam and other benzodiazepines, there are side effects and behavioral concerns that limit their usefulness. It is rapidly and completely absorbed by the body after it’s taken orally.
Clonazepam can cause serious side effects. Don’t stop taking clonazepam abruptly on your own, because a sudden stop can cause serious problems. Talk to your healthcare provider first.
Clonazepam Side Effects
The most common side effect of clonazepam is drowsiness, which occurs in about 50% of people being treated for seizures. About 30% experience a deficiency in the coordination of voluntary muscle movements that can include speech changes, walking abnormalities and abnormal eye movements. 9
Neurological:
Clonazepam can have neurological side effects such as:
- Abnormal eye movement
- Dizziness
- Vertigo
- Slurred speech
- Headache
- Fainting
- Nervousness
- Tremors
- Numbness
Psychiatric:
Psychiatric side effects include:
- Confusion
- Depression
- Hallucinations
- Hysteria
- Amnesia
- Changes in sex drive
- Sleeplessness
- Aggression
- Anxiety
People with a history of psychiatric problems are at a greater risk for psychosis as a side effect
Cognitive:
Other side effects include reduced intellectual ability, slow reaction time, memory disturbances and impaired judgement.
Due to these side effects, it’s recommended to be cautious about driving or operating machinery.
What Are the Long-Term Effects of Clonazepam on the Body?
One of the main long-term effects of clonazepam is that, just like any other benzodiazepine, a tolerance can build to the short-term effects, lessening the effectiveness of the drug. Tolerance, dependence and withdrawal are all harmful effects that are related to the long-term use of clonazepam. 10
When discontinuing Klonopin, individuals are at risk for developing rebound anxiety and withdrawal symptoms. Rebound anxiety may appear within the first week of stopping the drug and can last up to 6 weeks.
How Does Clonazepam Addiction Happen?
There are plenty of clonazepam addiction stories, and it can happen to anyone. After just a few weeks, physical dependence on clonazepam can occur, which results in withdrawal syndrome when the person reduces or suddenly stops taking the drug. It’s extremely dangerous to suddenly stop taking clonazepam.
Klonopin addiction can develop by taking the drug as prescribed to treat an anxiety or seizure disorder. The addiction often comes from misusing the drug: the dosage increases over time or dosing continues after a prescription expires. There are some cases where a person follows the prescribed limits and still develops a drug dependence on Klonopin.
In other cases, a dependence on the drug develops without a prescription. People acquire the drug illegally, take it and become addicted. In 2011, the Drug Abuse Warning Network (DAWN) reported more than 61,000 individuals went to emergency rooms due to an adverse reaction from non-medical or recreational use of clonazepam. 11 DAWN also reported that two of the most commonly reported prescription medications in drug abuse-related cases are opioid pain medications and benzodiazepines. 12
What Is the Detox from Clonazepam and Klonopin Like?
It is not recommended to detox at home, but instead undergo a medically supervised detox for health and safety reasons.
A clonazepam detox involves a gradual taper down of the drug while the person is monitored by medical professionals. As the doses of clonazepam are slowly decreased, doses of gabapentin are typically administered to minimize withdrawal symptoms. 13 Gabapentin is an anticonvulsant used to treat epilepsy; and it’s also used to treat certain types of nerve pain.
Antidepressants may be administered to control depression and thoughts of suicide. Melatonin may be used to help with insomnia.
Much of how the detox goes will depend on why the person is taking clonazepam in the first place. For example, if the person is taking the drug for a seizure disorder, as he or she is weaned off clonazepam, another anti-seizure or anticonvulsant drug may be introduced. If the person is taking clonazepam for a panic disorder, other anti-anxiety drugs may be introduced at the time of detox to prevent panic attacks during the detox.
Early Clonazepam Withdrawal Symptoms
Early withdrawal symptoms from clonazepam that can occur at the start include:
Tension: Heightened tension and irritability are a result of your GABA neurotransmitters no longer receiving the stimulation from Klonopin, which would help you stay calm. Small issues may irritate you during the first few weeks of withdrawal, but this should improve over time.
Headache: Headaches are a common withdrawal symptom that can range from severe (migraines) to mild. You can take over-the-counter headache medications for relief. Headaches should diminish as your body adjusts to functioning without Klonopin.
Insomnia: Many people start taking Klonopin to relieve insomnia. During withdrawal, it’s common to have difficulties with falling or staying asleep in the early stages. Partly, this can be due to increased anxiety. Taking melatonin can help.
Severe Clonazepam Withdrawal Symptoms
Benzodiazepines should not be stopped suddenly, because there is a risk of epileptic fits returning, confusion or paranoid psychosis. Other withdrawal symptoms from clonazepam can include:
Tremors: Tremors or uncontrollable shakes can happen when you stop taking Klonopin, because your body has developed a tolerance from taking the medication.
Hallucinations: Though rare, some individuals have hallucinations during Klonopin withdrawal.
Aggressiveness: You may react aggressively during Klonopin withdrawal due to the heightened anxiety and stress you may be feeling.
Nausea and Stomach Pain: If you experience nausea and stomach pain, it should subside within the first week or two after your last dose.
Sweating: Profuse sweating throughout the day and night sweats during sleep can occur during withdrawal. This can be due to the detox process in your body as it acclimates to functioning without the drug.
Dizziness: Benzodiazepine withdrawal can make you feel dizzy and unbalanced, but this is common and should subside within a few weeks.
Fatigue: Initially, you may feel excessively tired as well as a lack of motivation during withdrawal from a benzodiazepine like Klonopin. While it may be hard to get started in the morning and tackle daily tasks, your energy levels will gradually return.
Confusion: Confusion during withdrawal may be from poor cognitive functioning. This symptom typically improves gradually over a few weeks of withdrawal.
Anxiety: Klonopin works on receptors in your brain to reduce anxiety. Without it, your GABA neurotransmitter activity is significantly affected, which can increase anxiety during withdrawal.
Depression: Feeling depressed is a common occurrence during Klonopin withdrawal as the brain and body adjust to the reduction of the drug.
Seizures: People who take Klonopin for seizure control may experience an increased risk of developing seizures when they discontinue this drug, especially if they withdraw too rapidly. Even people without seizure disorders have increased risks of seizures if they stop Klonopin too quickly.
Thoughts of Suicide: Suicidal ideation is related to the depression many experience during Klonopin withdrawal. If you feel depressed, it may lead to feelings of hopelessness and suicidal thoughts. If this happens, tell someone who is supervising your withdrawal. Recognize that these thoughts are withdrawal-related and will improve in time.
Factors That Affect Clonazepam Withdrawal
Factors which may influence the symptoms and length of withdrawal include:
- High dosages: The higher the dose of clonazepam taken each time can mean more dependency on the drug, and thus a more intense withdrawal
- Length of time: The longer a person has taken, misused or abused Klonopin, the more dependent the brain may be on the substance
- Other substances: The abuse of other drugs at the same time can make the withdrawal more complicated
- Co-occurring disorders: Medical and mental health issues can complicate or be exacerbated during withdrawal
- Genetics: Some individuals may be more susceptible to withdrawal effects than others
Generally speaking, the more dependent the brain is on Klonopin, the longer and more uncomfortable withdrawal may be.
What Are Common Struggles When Getting Sober from Clonazepam?
A common struggle in getting sober from clonazepam addiction is, if you were taking the medication for convulsion prevention, you now have to find a replacement drug. This can be especially difficult if clonazepam was effective in preventing seizures, but you had to quit using it because of an active or developing addiction.
The same would apply if you were taking the drug for insomnia or a panic disorder. Talk with your healthcare clinician about what medications would effectively treat your condition(s) that are not in the benzodiazepine family.
Where Can You Find Help With Clonazepam Dependence and Addiction?
The team at Silvermist Recovery are licensed, credentialed and experienced in the treatment of Klonopin addiction. We are a dedicated and compassionate clinical staff that provides multiple treatment modalities.
Our team develops an individualized treatment plan for you or your loved one. We’ll help you reach and maintain a sober life. Treatment at Silvermist can help you or a loved one make the positive changes needed to live a renewed and addiction-free life. Call today to get started on the journey to recovery.
Resources:
- https://www.mdpi.com/2226-4787/6/2/43
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453238/
- https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
- https://books.google.ca/books?id=juAJCAAAQBAJ&pg=PT66#v=onepage&q&f=false
- https://livertox.nlm.nih.gov/Clonazepam.htm
- https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5efa6cc2-1504-4538-98dd-c94d89511767
- https://www.drugabuse.gov/drugs-abuse/opioids/benzodiazepines-opioids
- https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/what-scope-prescription-drug-misuse
- https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ebc11109-e7bf-452d-b675-4b3236d54164
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/
- https://www.samhsa.gov/data/sites/default/files/DAWN2k11ED/DAWN2k11ED/DAWN2k11ED.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4020178/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782857/
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