Clonazepam is prescribed for short term management of epilepsy, anxiety, and panic disorderwith or without agoraphobia.
Clonazepam, like other benzodiazepines, while being a first-line treatment for acute seizures, is not suitable for the long-term treatment of seizures due to the development of tolerance to the anticonvulsant effects.
Clonazepam has been found effective in treating epilepsy in children, and the inhibition of seizure activity seemed to be achieved at low plasma levels of clonazepam.As a result, clonazepam is sometimes used for certain rare childhood epilepsies; however, it has been found to be ineffective in the control of infantile spasms.
Clonazepam is mainly prescribed for the acute management of epilepsies. Clonazepam has been found to be effective in the acute control of non-convulsive status epilepticus; however, the benefits tended to be transient in many people, and the addition of phenytoin for lasting control was required in these patients.
It is also approved for treatment of typical and atypical absences (seizures), infantile myoclonic, myoclonic, and akinetic seizures. A subgroup of people with treatment resistant epilepsy may benefit from long-term use of clonazepam; the benzodiazepine clorazepate may be an alternative due to its slow onset of tolerance.
- Panic disorder with or without agoraphobia.
- Clonazepam has also been found effective in treating other anxiety disorders, such as social phobia, but this is an off-label use.
The effectiveness of clonazepam in the short-term treatment of panic disorder has been demonstrated in controlled clinical trials. Some long-term trials have suggested a benefit of clonazepam for up to three years without the development of tolerancebut these trials were not placebo-controlled. Clonazepam is also effective in the management of acute mania.
Restless legs syndrome can be treated using clonazepam as a third-line treatment option as the use of clonazepam is still investigational.Bruxism also responds to clonazepam in the short-term. Rapid eye movement sleep behavior disorder responds well to low doses of clonazepam.
- The treatment of acute and chronic akathisiainduced by neuroleptics, also called antipsychotics.
- Spasticity related to amyotrophic lateral sclerosis.
- Alcohol withdrawal syndrome
- Benzodiazepines, such as clonazepam, are sometimes used for the treatment of mania or acute psychosis-induced aggression. In this context, benzodiazepines are given either alone, or in combination with other first-line drugs such as lithium, haloperidol or risperidone.The effectiveness of taking benzodiazepines along with antipsychotic medication is unknown, and more research is needed to determine if benzodiazepines are more effective than antipsychotics when urgent sedation is required.
- Many forms of parasomnia and other sleep disorders are treated with clonazepam.
- It is not effective for preventing migraines.