Clonazepam
Klonopin
BenzodiazepineSchedule IVGeneric availableTDM data
Clinical Pharmacology The precise mechanism by which clonazepam exerts its antiseizure and antipanic effects is unknown, although it is believed to be related to its ability to enhance the activity of gamma aminobutyric acid (GABA), the major inhibitory neurotransmitter in the central nervous system.
Compare Clonazepam →FDA-Approved Indications
- panic disorder, with or without agoraphobia, as defined in DSM-V
Common Off-Label Uses
- Social anxiety disorder
- REM sleep behavior disorder
- Restless legs syndrome
- Burning mouth syndrome
- Acute mania (adjunct)
What Sets This Drug Apart
- Longest-acting high-potency benzodiazepine (t1/2 30-40h); provides smoother plasma levels than alprazolam with less interdose withdrawal
- Broadest FDA indication set among benzos: anxiety, panic disorder, and seizure disorders (Lennox-Gastaut, akinetic, myoclonic, absence seizures)
- Only benzodiazepine used as solo maintenance anticonvulsant; second-line for petit mal seizures
- Once-to-twice-daily dosing is sufficient due to long half-life — practical advantage over short-acting alternatives
- Significant abuse potential despite long half-life; tolerance and withdrawal still occur with chronic use
Boxed Warning
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS