Indication
Clonazepam is used for certain types of seizures, specifically petit mal seizures, akinetic seizures, and myoclonus, as well as lennox-gastaut syndrome. For these seizure disorders, Clonazepam may be used alone or together with other medications. It is also used for panic disorder, social phobia, mania, and post-traumatic stress disorder.
Dosage And Administration
Must be determined individually according to clinical response and tolerance and depends primarily on the patient’s age.
Side Effects
The most frequently occurring side effects of Clonazepam are referable to CNS depression, drowsiness, fatigue, dizziness, muscle hypotonia, co-ordination disturbance, hypersalivation in infants, paradoxical aggression, irritability and mental change.
Contraindications
Clonazepam should not be used in patients with a history of sensitivity to benzodiazepine, nor in patients with clinical or biochemical evidence of significant liver disease. It may be used in patients with open angle glaucoma who are receiving appropriate therapy, but is contraindicated in acute narrow angle glaucoma.
Drug Interactions
The CNS depressant action of the benzodiazepine class of drugs may be potentiated by alcohol, narcotics, barbiturates, nonbarbiturate hypnotics, antianxiety agents, the phenothiazines, thioxanthine and butyrophenon classes of antipsychotic agents, monoamine oxidase inhibitors and the tricyclic antidepressant and other anticonvulsant drugs.
Precautions
Although simultaneous administration of several anticonvulsants may be considered with Clonazepam, such combined 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 optimum effect. Abrupt withdrawal of Clonazepam particularly in those patients on long-term, high dose therapy, may precipitate status epilepticus. Therefore, as with any other anticonvulsants, gradual withdrawal is essential when discontinuing Clonazepam. While Clonazepam is being gradually withdrawn, the simultaneous substitution of incremental doses of another anticonvulsant may be indicated. Use in pregnancy and lactation: The use of Clonazepam during pregnancy or lactation should be avoided. Clonazepam is excreted into the breast milk and should therefore be avoided in breast-feeding mother. Occupational hazards: Patients receiving Clonazepam should be in caution during hazardous occupations requiring complete mental alertness, such as operating machinery or driving a motor vehicle. They also should be warned against the concomitant use of alcohol and other CNS depressant drugs.
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