Clonazepam Anti Anxiety

Clonazepam's pharmacological profile is similar to other sedative or anxiolytic benzodiazepines. The basic anticonvulsive properties of Clonazepam are also similar to those of other diazepines. Alone or as an adjunct in the management of myoclonic and akinetic seizures and petit mal variant may also be of some value in patients with absence spells (petit mal) who have failed to respond to succinimides.

Although immediate administration of several anticonvulsants may be considered with clonazepam doses, such combined anti anxiety therapy may result in an increase of central depressant adverse effects. In addition, the dosage of each drug may be required to be adjusted to obtain the best possible outcome. Abrupt withdrawal of clonazepam particularly in those anxiety sufferers on long-term, high dose therapy may precipitate status epilepticus. Therefore, as with any other anticonvulsants, or anti anxiety drugs gradual withdrawal is essential when discontinuing clonazepam. While clonazepam is being gradually withdrawn, the simultaneous replacement of incremental doses of another anticonvulsant drug may be indicated.

Caution and anxiety sufferers receiving clonazepam against engaging in hazardous occupations requiring complete mental alertness, such as operating machinery or driving a motor vehicle. The sufferers also should be warned against the concomitant use of alcohol and other central nervous system depressant drugs. The central nervous system depressant action of benzodiazepines may be resulted by other drugs such as narcotics, alcohol, barbiturates, anxiolytics, nonbarbiturate hypnotics, phenothiazines, thioxanthene and butyrophenone antipsychotic agents, MAO inhibitors and tricyclic antidepressants. Benzodiazepines have created dependence, habituation and withdrawal symptoms similar to those noted with barbiturates and alcohol. Therefore, anxiety sufferers who may be prone to increasing the dose of drugs on their own initiative should be under careful monitoring while receiving clonazepam. Periodic liver function tests and blood corpuscles counts are recommended during long-term clonazepam therapy. The most commonly occurring adverse reactions to clonazepam are referable to central nervous system depression. Drowsiness occurs in approximately 50% of sufferers and ataxia in approximately 30%.

In some cases, these reactions may diminish with time. Behavioural disorders have been noted in approximately 25% of patients and increased salivation in 7%. There several other alterations in behavior, which have been variously reported as argumentative behavior, aggressiveness, hyperactivity, agitation, euphoria, depression, irritability, forgetfulness and confusion. These behavioral reactions are particularly likely to occur in sufferers with a prior history of psychiatric disturbances and are known to occur in patients with chronic seizure disorders. Other adverse behavioral reactions involving the central nervous system have included unsteady gait, nystagmus, dysarthria, slurred speech, vertigo, insomnia, and diplopia. Isolated reports of hemiparesis, akinesia, hypotonia, tremor, headache and choreiform movements have been received. Increased nausea, vomiting, salivation, anorexia, diarrhea, constipation, encopresis, dry mouth, increased appetite, abdominal pain, hepatomegaly. Rare instances of dysuria are incontinence, nocturia, urinary retention, and enuresis. Nonspecific instancec are erythematous, papular and maculopapular rashes, swelling of the face and eyelids, pruritus, urticaria. Hirsutism, muscle weakness, low back pain and hair loss have also been reported, but drug relationship has not been clearly established. Hypersecretion in the upper respiratory passages, dyspnea, rhinorrhea, respiratory depression etc have also been seen in some cases.

• John Palsson
• 16/12/2008, 10:59 PM
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