Klonopin belongs to the group of benzodiazepines. The drug acts on many structures of the central nervous system, first of all, on the limbic system and hypothalamus, i.e. structures related to regulation of emotional functions. Like all benzodiazepines, Klonopin increases the inhibitory effect of GABA neurons in the cortex, hippocampus, cerebellum, medulla and other structures of the central nervous system. This results in decreased activity of various groups of neurons: noradrenergic, cholinergic, dopaminergic and serotoninergic.
Klonopin in drug addicts, in particular in patients with alcohol and opioid addiction, promotes normalization of sleep, decreases painful muscle cramps (due to its myorelaxant effect), eliminates anxiety, helps to prevent seizures (which is especially important in treatment of alcohol withdrawal syndrome), has vegetostabilizing effect and decreases vegetative disorders associated with withdrawal syndrome (alcohol or opioid). This leads to improvement with respect to stability and duration of remission states, especially in adolescent alcoholism. The long elimination half-life of Klonopin and its relative benignity with respect to cognitive function and impact on socialization and daily activities of patients dependent on barbiturates or alcohol has led some Western authors to even propose Klonopin as a model of long-term substitution therapy in such patients, similar to methadone substitution therapy in patients with opioid dependence. At the same time, this kind of substitution therapy has been shown to be effective and safe and does lead to improvements in socialization and daytime activities as well as parameters of cognitive functioning in barbiturate-dependent patients.
Indications
- All forms of epilepsy in adults and children (mainly akinetic, myoclonic, generalized submaximal temporal and focal attacks)
- focal epileptic seizures simple and complex;
- secondary conditioned simple attacks;
- small seizures (petit mal), including atypical ones
- primary and secondary tonic-clonic seizures (grand mal)
- attacks of myoclonic and clonic convulsions and other conditions of motor excitation;
- Lennox-Gastaut syndrome
- paroxysmal fear syndrome, states of fear, phobias (agoraphobia) – except for patients under 18 years of age.
Contraindications
- Hypersensitivity to a benzodiazepine or to any component of the drug
- respiratory disorders of central origin and respiratory failure of various origins, sleep apnea syndrome,
- disorders of consciousness;
- glaucoma;
- myasthenia gravis;
- severe liver and kidney failure
- lactation.
Dosage and administration
The dose is selected individually and depends on the patient’s response to the drug intake. Treatment should start with low doses (0.5 mg), gradually increasing them (from 0.5 to 1 mg every 3 days) until an appropriate therapeutic effect is obtained or the maximum daily dose is reached. Treatment with the drug should not be abruptly interrupted. Gradual reduction of the dose, even after short-term use, is recommended. Abrupt discontinuation of Klonopin provokes epileptic seizures.
Side effects
The most common side effects of Klonopin treatment are observed in the central nervous system: feeling of fatigue, muscle weakness, impaired coordination of movements, dizziness, ataxia, hypersensitivity to light. These symptoms are often temporary and disappear spontaneously with continuation of treatment or with reduction of the drug dose. Decreased concentration, sleep disturbances, confusion, disorientation, retrograde amnesia, behavioral disturbances, and depression may increase with increasing dosage of the drug. It should be remembered that memory impairment and depression may be caused both by the treatment and by a sign of the underlying disease.
