Clonazepam

Overview

Highly potent, long-acting benzodiazepine. Exhibits profound anticonvulsant and anxiolytic properties. Less sedating than diazepam but carries a massive risk of physical dependence.

Maximum Dose

Max 8 mg/day (Usually 1-4 mg/day for panic/seizures).

Clinical Focus

0.5 mg of Clonazepam is roughly equivalent to 10 mg of Diazepam. Do not miscalculate the potency.

Bottom Line

Clonazepam is a long-acting benzodiazepine for epilepsy and panic disorder, but has high dependence potential and abrupt withdrawal can cause life-threatening seizures.

Brand Names

Rivotril, Paxam

Oral Routes

Tablets (500 mcg, 2 mg). Oral liquid drops (2.5 mg/mL).

Parenteral

Ampoules (1 mg/1 mL) for IV use.

Prescribing & PBS

Authority Required (PBS) for epilepsy. Private for anxiety.

Primary

Epilepsy (myoclonic, absence, focal), severe panic disorder.

Off-Label

REM sleep behavior disorder, severe acute mania, restless legs syndrome.

Clinical Place

Preferred benzo for seizure prevention and chronic panic disorder due to stable blood levels (long half-life prevents inter-dose withdrawal).