Clonazepam (Rivotril): what is it and what is it used for?

Clonazepam, which has one of its best-known brands in Rivotril ®, It is a drug that exerts its action on the central nervous system. Specifically, it is a valuable active ingredient for addressing the symptoms of conditions such as epilepsy, panic attack, and generalized anxiety disorder.

In this article we are going to know what its indications are, its adverse effects and the precautions that we must take into account during its consumption. Remember that this is a mandatory prescription medication, so it is not suitable for self-medication and should always be taken based on the instructions of a health professional.

What is clonazepam?

The active ingredient clonazepam, marketed under the brand name Rivotril ®, among others, It is a benzodiazepine used primarily as an antiepileptic., both for children and adolescents and for adults. We can find it in various pharmacological presentations; in tablets, oral drops and also in injectable preparation (intravenous or intramuscular), as detailed StatPearls.

Mechanism of action

The brain is made up of billions of neurons, which communicate with each other using electrical and chemical signals. These signals are transmitted through neurotransmitters.

One of these neurotransmitters is gamma-aminobutyric acid or GABA. It is an inhibitory substance, which means that it has the ability to reduce neuronal activity, as detailed in a publication by Trends in Pharmacological Sciences.

Therefore, helps reduce excitation and excessive activity of brain neurons. So it reduces anxiety, seizures and other neurological disorders.

Specifically, clonazepam increases the activity of the neurotransmitter GABA, by binding to certain receptors. When bound, it enhances the action of GABA, leading to a decrease in neuronal activity. The result is a feeling of calm and relaxation.

What is it prescribed for?

Clonazepam has antiepileptic, sedative, muscle relaxant and anxiolytic effects.. Therefore, its medical indications are linked to these effects, as developed by the specialized portal MedlinePlus.

One of the most common uses is the treatment of epilepsy.. Epilepsy is a neurological disorder characterized by the presence of recurrent seizures. Clonazepam decreases neuronal excitability, which helps prevent seizures.

In cases of continued seizures, within the condition known as status epilepticus, intravenous injection of the drug can reduce the period of the acute attack. In addition, it can also be used in other types of seizures, such as those associated with Lennox-Gastaut syndrome.

Clonazepam has also shown effectiveness in panic attack disorder. This condition is characterized by the appearance of acute anxiety, accompanied by palpitations, difficulty breathing and a feeling of loss of control. In this case, acts as an anxiolytic agent.

Finally, another common indication of the active ingredient is the treatment of generalized anxiety. Here, it acts as a modulator, helping to reduce symptoms of restlessness, stress and excessive worry.

What are the side effects of clonazepam?

This drug has some adverse effects that occur more frequently:

Drowsiness: This can affect a person’s ability to be alert and concentrate. It is important to use caution when doing activities that require attention, such as driving or operating heavy machinery.Dizziness: It is advisable to get up slowly from a sitting or lying position if you are being treated with clonazepam. Difficult to focus: It can affect the ability to concentrate and cognitive performance in some people. There will be difficulties processing information or maintaining attention on specific tasks.Motor coordination problems: It can manifest as a lack of balance or clumsiness in the finest movements.

Serious side effects

In addition to those already mentioned, it is possible that adverse effects may appear during consumption that are severe and require immediate attention, such as the following:

Dependency and abuse: Clonazepam can cause physical and psychological dependence if used for a long time or in high doses.Mood changes: Some occurrence of suicidal thoughts has been recorded in susceptible people.Respiratory problems: In rare cases, shortness of breath or a decrease in respiratory rate may appear.Allergic reactions: Clonazepam allergy manifests itself with skin rashes, itching, swelling of the face, or difficulty breathing.

If you detect unwanted effects derived from the administration of the drug, you should consult a specialist. The doctor will consider whether a change in dosage is necessary.

Treatment should not be suspended without medical indication. Abrupt discontinuation, without cessation with progressive reduction of doses, leads to withdrawal syndrome.

Recommended clonazepam doses may vary depending on medical condition and individual needs. It is always important to follow a doctor’s instructions and never adjust the dosage on your own.

Only a healthcare professional can prescribe clonazepam.

As a general reference, the most frequently used doses are usually the following, based on information from StatPearls:

Panic disorder: It starts with 0.25 mg to 0.5 mg per day, in two doses. Gradual increases are then made from 0.25 mg to 0.5 mg every 3 days. The maximum recommended daily dose is 4 mg.Epilepsy: The initial dose is 1.5 mg per day, divided into three doses. It may be increased to 0.5 mg every 3 days until seizure control is achieved. The maximum recommended daily dose in this case is 20 mg.

In case of an overdose, symptoms such as drowsiness, nystagmus, decreased coordination of movements or difficulty speaking will appear. To prevent progression to a potentially fatal condition, it is necessary to apply flumazenil, a substance that works as an antagonist of benzodiazepines.

Clonazepam is a central nervous system depressant and may potentiate the effects of substances such as alcohol. So it should not be combined with alcoholic beverages or those with high caffeine content.

Clonazepam and society

The massive use of clonazepam has serious repercussions on society. This drug, useful for treating certain pathologies, is increasingly consumed in an unregulated and self-medication manner.

The associated problems are not only social, but also economic, as analyzed in a publication in Mental Health Clinician. Overuse of benzodiazepines increases work absenteeism, impairs academic performance, and promotes job loss. Besides, personal and family relationships can be affected.

The risks to public safety are no less when these active ingredients are used without responsibility. The medication can affect people’s attention span, motor coordination, and judgment, increasing the likelihood of traffic accidents and other incidents.

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