What Is Klonopin? How Is It Used?
Chemist Leo Sternbach, working for the global healthcare company Hoffmann-La Roche, accidently discovered the drug chlordiazepoxide (Librium) in 1955.
The drug was made available in the United States in 1960. This was the beginning of the development and marketing of one of the most celebrated and at the same time maligned classes of prescription drugs in the world. Sternbach went on to discover similar drugs, such as:
- Valium (diazepam)
- Dalmane (flurazepam)
- Rohypnol (flunitrazepam)
- Klonopin (clonazepam).
All these drugs belong to the same class, which remains one of the most prescribed classes of drugs in America. Valium was released in 1963 and became the most prescribed drug in the United States, with more than 2.3 billion prescriptions in 1978. In 1977, benzodiazepines, the class that all the aforementioned drugs belong to, were the most prescribed drugs in the world. These drugs remain among the most prescribed drugs in the United States.
Sternbach developed Klonopin in 1964, and it was first marketed in the United States in 1975.
What Are Benzodiazepines?
Benzodiazepines are a class of drugs that all affect the neurotransmitter gamma-aminobutyric acid, most often called GABA. GABA is the most common inhibitory neurotransmitter in the brain, meaning that when it is released, it results in slowing the activities of all the other neurons in the brain. Thus, benzodiazepines are psychoactive substances that are generally classified as anxiolytic drugs (anti-anxiety drugs) or anti-epileptic drugs (drugs that control seizures). They act as central nervous system depressants. Psychoactive drugs are chemical substances that affect the brain and alter the person’s mood, cognitive functioning (thinking), and perception.
Benzodiazepines are used clinically for a number of conditions. They are most often prescribed as:
- Short-term treatment for the management of anxiety
- Short-term treatment of seizures
- Medications to manage anxiety, irritability, restlessness, and insomnia in people who have atypical depression
- Sleep aids
- Muscle relaxants
- Treatment to aid in withdrawal from alcohol
- Medications to aid in addiction treatment
Benzodiazepines have also been used in the treatment of other psychiatric disorders, such as bipolar disorder or schizophrenia.
What Is Klonopin?
Klonopin is a benzodiazepine medication that was initially primarily used for the treatment of seizures occurring in epilepsy and for anxiety, specifically anxiety that occurs in panic disorder. Klonopin is available in tablet form (0.5 mg, 1 mg, 2 mg) and as disintegrating wafers that are taken orally.
While Klonopin is generally prescribed for the treatment of anxiety disorders, such as panic disorder, and seizure control, it is intended as a short-term treatment protocol as opposed to a long-term treatment solution due to issues with tolerance (see below). In addition to treating anxiety and seizures, Klonopin has also been used in the treatment of:
- Schizophrenia, especially when the individual with schizophrenia has a restless or irritable component and is not responding to antipsychotic medications
- The manic phase of bipolar disorder or for restlessness associated with depression in bipolar disorder
- Tic disorders, such as Tourette’s syndrome, by acting as a muscle relaxant and producing sedation.
- Restless leg syndrome
- Withdrawal from alcohol or treatment for other substance abuse or addiction issues
- Other conditions.
Klonopin has a relatively slow onset of action (it takes a while for the drug to begin working) and a half-life of between 10 and 50 hours. As it has a relatively slow onset of action and is a longer-acting benzodiazepine, Klonopin is more suited for the treatment of anxiety, seizures, and other similar disorders as opposed to being a useful sleep aid, even though it is sometimes prescribed for that purpose. Sleep aids need to work quickly, whereas with Klonopin, a person takes the drug early in the day and doesn’t have to worry about monitoring for signs of a seizure or panic attack as it stays in the system a relatively long time. Its effects last longer than those of shorter-acting benzodiazepines, such as Xanax.
As it is a Schedule IV controlled substance, Klonopin can only be legally acquired with a prescription from a physician.
What Effects Does Klonopin Produce?
Generally, the effects of Klonopin include:
- A reduction in anxiety
- A general feeling of wellbeing
- Mild euphoria
- Slowed reflexes
Klonopin is also associated with a number of potential side effects that may not be serious and will often dissipate after the person has been taking the medication for a while. Some of the side effects of taking Klonopin that are considered to be less serious include:
- Sedation or drowsiness, dizziness, and decreased thought production
- Muscle weakness, problems with balance, and problems with coordination
- Slurred speech
- Dry mouth, sore gums, and mild drooling
- Blurred vision
- Mild headache
- Decreased appetite
- Constipation or diarrhea
- Puffy eyes, stuffy nose, and runny nose
- Weight gain
- Difficulties with attention or memory
- Sometimes, paradoxical effects occur when people take Klonopin (effects that contradict what the expected effects should be), such as:
- More serious side effects that may occur from Klonopin use include:
- Extremely depressed or shallow respiration
- Aggressive behavior
- Dangerous uninhibited behaviors, such as unusual risk-taking behaviors
- Disinhibited behaviors
- Increased heart rate
- Difficulty urinating or painful urination
- Anxiety or panic attacks
- White or pale skin tone, accompanied by easily bruising
- However, these effects appear to be rare.
- Hallucinations or delusions
- Suicidal thoughts
- The appearance of any these side effects indicates that the person needs immediate medical attention.
Benzodiazepines like Klonopin became popular prescription medications, as alternatives to another class of anti-anxiety medications called barbiturates. Barbiturates were once very popular in the treatment of anxiety; however, they were highly addictive, carried a high risk for overdose, and were frequently abused. Benzodiazepines also carry a significant risk for the development of physical dependence and abuse (see below); however, they do not appear to carry the same risk of overdose that is associated with barbiturates (although overdose on benzodiazepines can occur).
Many of the cases of overdose that include benzodiazepines also include the co-occurring use of other drugs, such as alcohol, narcotic pain medications, or antidepressants. Using these drugs and benzodiazepines like Klonopin together enhances the effects of all drugs as well as increases the risk for overdose and potential fatalities due to drug interactions and drug overdose.
Cognitive Impairment from Klonopin Use
Klonopin results in a depression of the activities of the central nervous system. This depression is not meant to designate a feeling of depressed mood, although some people may experience depressed mood as a side effect of Klonopin use. It instead relates to a reduction in the rate of activity of the cells in the brain. This reduction in the rate of brain activity affects several cognitive functions, most notably the ability to form new memories. Memories are formed in the brain as a result of increased activity of neurons, and a person using a benzodiazepine like Klonopin will experience a dampening of these processes that can interfere with the ability to form new memories while one is taking the drug.
There is some evidence that cognitive abilities, such as memory, attention, visual spatial skills, and even intellect, might be affected as a result of long-term benzodiazepine abuse; however, the research in this area is limited due to many of the subjects in the studies having a history of abusing benzodiazepines and other substances, such as alcohol.
It appears that elderly individuals are particularly vulnerable to adverse effects from long-term usage.
The use of any benzodiazepine over a lengthy period of time can result in both tolerance (the need for an increased amount or potency of the drug to achieve the effects that were achieved when one first began taking it) and withdrawal (a series of negative symptoms that occur when one stops using the drug, such as nausea, vomiting, chills, and emotional and cognitive problems that can include hallucinations and even seizures).
When individuals have developed both tolerance and withdrawal symptoms as a result of using a drug, they have developed a physical dependence on the drug, indicating that the body has developed a reliance on the drug in order to function.
While those with addictions may or may not have a physical dependence on a drug, their use of the drug is not to experience therapeutic benefits, but instead represents a disordered pattern of behavior where drug usage has become a type of emotional or psychological crutch. The addiction interferes with and results in impairments in areas of everyday functioning, such as issues with work, family life, social functioning, and school.
When an individual’s use of Klonopin interferes with everyday functioning, there are other signs of addiction that may also be present. These include:
- Sleepiness throughout the day
- Slurred speech
- Very slow reaction times
- Difficulties with memory
- Acquiring Klonopin illegally and taking it for its euphoric effects
- Taking Klonopin with other drugs, such as alcohol, painkillers, illegal drugs, etc.
- Taking significantly higher amounts of Klonopin than prescribed or taking the drug more often than prescribed
- Doctor shopping to obtain more Klonopin
- Spending significant amounts of time trying to obtain the drug
- Spending significant amounts of time using Klonopin or spending significant amounts of time recovering after use
- Isolating oneself from others in order to use Klonopin
- Becoming extremely defensive or angry regarding one’s use of the drug
- Continuing to use Klonopin despite experiencing negative effects from using the drug, such as issues with the person’s health, issues at work, family issues, issues at school, etc.
- Irritability, restlessness, or agitation
- Flu-like symptoms or nausea and vomiting
- Psychotic symptoms, such as hallucinations or appearing to be paranoid
- Becoming aggressive or violent
People do not need to display all of these signs to have an addiction. If people display two or more of the above signs, and their use of the drug is negatively affecting their lives in the areas mentioned above, there is cause for concern.
Abuse of and addiction to benzodiazepines, such as Klonopin, have received quite a bit of attention in the last several years, especially due to cases of celebrities who either accidentally overdosed on these drugs or who committed suicide and had benzodiazepines in combination with other drugs in their system. One celebrity who has been very outspoken regarding her addiction to Klonopin is Stevie Nicks of the band Fleetwood Mac. She has spoken out on several occasions regarding how her abuse of Klonopin had serious repercussions on her health and personal life.
Because tolerance to the therapeutic effects of all benzodiazepines will eventually occur – though tolerance occurs at different rates depending on the particular drug and on the person – use of these drugs for the treatment of anxiety and seizure disorders should be a short-term endeavor. There is some controversy regarding long-term use of benzodiazepines for these conditions that is complicated by the fact that there are empirically validated therapies for anxiety disorders and other medications for seizures that have evidence of long-term effectiveness. In addition, other drugs such as the selective serotonin reuptake inhibitors (e.g., Zoloft, Prozac, Paxil, etc.) have also been found to be useful in the treatment of anxiety and do not share the same potential for abuse as benzodiazepines like Klonopin. Nonetheless, Klonopin and other benzodiazepines continue to be prescribed as long-term treatments in some instances.
Treatment Options for Abuse and Addiction
Individuals who want to stop using Klonopin as a result of an abuse or addiction issue are faced with several options that include:
- Attempting simply to cut down on Klonopin use alone and without help
- Attempting to quit using Klonopin on their own without help
- Entering an inpatient treatment program for Klonopin abuse/addiction
- Entering an outpatient program for Klonopin abuse/addiction
- Getting involved in support groups, such as Narcotics Anonymous
It is important that anyone with a substance abuse or addiction issue realize that the first two options on the above list are not going to solve the problem. The vast majority of individuals who attempt to simply cut down their use of a substance they are abusing or addicted to may have limited success initially, but in the long-term, they usually revert back to their old habits.
Because substance abuse and addiction are such serious issues, attempting to quit or “control” one’s use of a drug without professional help is nearly always unsuccessful. This attitude represents an extension of the illogical thinking processes that are associated with substance abuse or addiction. For most individuals, the best option is to seek professional help to address the substance abuse or addiction.
Because Klonopin users will have typically developed physical dependence, they will need to initially participate in some type of a supervised medical detox program. This requires the assistance of a physician who can help the person go to the withdrawal process without experiencing serious physical effects of Klonopin withdrawal.
Detox alone will not be enough to help the individual change the behavior related to Klonopin abuse.
Individuals with abuse or addiction issues require assistance to restructure their thinking process, to learn coping methods, and to develop and implement a plan of action to avoid relapse.
Even if an individual initially decides to enroll in inpatient treatment, the person will eventually need to choose some form of long-term aftercare treatment or get involved in a support group that is designed to support long-term recovery. Most individuals with substance abuse or addiction problems find they are more successful in avoiding relapse if they maintain some type of long-term aftercare program.
Addressing one’s abuse of Klonopin is best accomplished by enrolling in a treatment program that makes considerations for both short-term and long-term sobriety.