Klonopin (clonazepam) is in a class of anxiolytic (antianxiety and antipanic) medications called benzodiazepines. It works by decreasing abnormal electrical activity in the brain. Doctors prescribe this drug to treat seizures and panic attacks. Off-label use (meaning not indicated on the U.S. Food and Drug Administration-approved packaging) includes restless legs syndrome, sleepwalking, and social phobia in adults.
Klonopin has been prescribed for a number of neurological conditions, such as epilepsy and anxiety, since the 1950s and 1960s. Klonopin was originally brought to market in 1975 to treat epileptic seizures.
- What is a safe dose of this drug?
- Panic and anxiety: An initial adult dose of Klonopin is 0.25 mg two times a day. The dose can be increased to 1 mg per day every three days. The maximum dose of this drug should not exceed 4 mg per day. In such cases, the dose of Klonopin may be increased by 0.125 mg to 0.25 mg two times a day every three days until panic is controlled.
- Seizures: Klonopin is useful alone or as an adjunct in the treatment of Lennox-Gastaut, akinetic, and myoclonic seizures. An initial adult dose should not exceed 1.5 mg per day in three divided doses. Dosage may be increased by 0.5 mg to 1 mg every three days until the conditions improve. A maintenance dosage of this drug must be given according to individual need and depending upon response. Maximum daily dose should not exceed 20 mg.
- Posttraumatic stress: Doses of Klonopin for PTSD typically range from 0.25 mg to 3 mg per day.
- Social phobia in adults: For social phobia, a dose ranging from 1 mg to 2.5 mg is usually administered.
- What are other off-label uses for this drug?
Off-label use refers to any time a doctor uses this drug for treatment not specified by the FDA packaging. This is a regular practice and for this drug includes:
- Burning mouth syndrome
- Essential tremors
- Tourette syndrome
- Major depression
- Multiple sclerosis
- Periodic limb movement disorder
- Restless legs syndrome
- West syndrome (infantile spasms)
- How is this drug processed by my body?
Klonopin is well-absorbed after oral administration and reaches a maximum plasma concentration after one to four hours. It has a bioavailability of about 90%. 85% of this drug is bound to plasma protein. The elimination half-life of Klonopin is typically 30 to 40 hours. Less than 2% of unchanged Klonopin is excreted in urine. Metabolites are also excreted in the urine.
- Is this drug safe to use while pregnant?
The FDA has placed this medication in pregnancy category D, which means there is evidence of risk to human fetuses during pregnancy. However, many conditions for which this medication is prescribed also pose a risk to pregnant mothers and their babies. A thorough assessment should be performed by you and your doctor to determine if the risks outweigh the benefits if you are prescribed this drug.
- How can I get the most out of my treatment with this drug?
Panic and anxiety, two conditions treated with this drug, are also treated with success by various types of psychotherapy. If you are experiencing anxiety or panic, consider finding a therapist or counselor to help you develop healthy coping strategies, learn more about what you are experiencing, and develop a self-care routine to mitigate symptoms in the future.