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The anticonvulsant drug of benzodiazepine series Klonopin has a therapeutic effect due to the main component of Clonazepine. The drug enhances the effect of gamma-aminobutyric acid, slowing the transmission of nerve impulses, reduces the excitability of the cerebral subcortex, and the speed of postsynaptic spinal reflexes. Presynaptic inhibition helps to prevent the spread of epileptogenic activity without affecting the excitation in the hearth.
Clonazepam, as a means of I series, is prescribed for use in epilepsy: atypical and typical absences, nodding convulsions, atonic seizures. As a means of the II series, the drug is prescribed for the treatment of infantile spasms. Klonopin is used as a means of III series in tonic-clonic seizures, partial seizures, secondarily generalized seizures. The intravenous introduction of the drug is prescribed in case of epilepsy.
The use of Clonazepam is indicated in somnambulism, muscle hypertonicity, psychomotor agitation, insomnia, alcohol withdrawal, panic attacks. The anxiolytic effect of Klonopin is manifested by the reduction of emotional tension, anxiety, and fear through interaction with the amygdala complex. The drug reduces neurotic symptoms by affecting the nonspecific nuclei of the optic tubercle and reticular formation. In addition to the anticonvulsant effect, Clonazepam has a muscle relaxant, hypnotic, and sedative effects.
Clonazepam pills are intended for oral use, and the solution is for intravenous administration. The effective dose is calculated individually. The daily dose is divided into 3-4 receptions. The maintenance therapy is started within 14-21 days after the start of treatment. When the drug is administered intravenously, the single dose is 1 mg for adults and 500 mcg for children. Klonopin should be diluted with the supplied solvent for parenteral use.
As for the adults, at the beginning of therapy, the use of 1 mg/day is indicated., the maintenance dose is 4-8 mg/day. Children from 1 year to 5 years should start treatment with the use of up to 250 mcg/day, older than 5 years – 500 mcg/day. The maintenance therapy for children up to a year is 0.5-1 mg/day., 1-5 years – 1-3 mg/day., 5-12 years – 3-6 mg/day. Elderly patients begin treatment with 500 mcg/day.
Clonazepam treatment often provokes the development of headache, lethargy, fatigue, drowsiness, dizziness, lethargy, numbness. Infrequently, hypotension, agranulocytosis, tachycardia, respiratory depression, leukopenia, anemia, thrombocytopenia, neutropenia, transient alopecia develop against the background of the use of the drug.
Rarely, the use of Klonopin contributes to the development of ataxia, liver disorders, confusion, articulation disorders, diplopia, paradoxical reactions, hyperergic reactions, dry mouth, nystagmus, nausea, stool disorders, decreased appetite, dysmenorrhea, changes in libido, kidney disorders, allergic reactions, pigmentation changes, anterograde amnesia, urinary incontinence. For children, the characteristic side symptoms are increased salivation, bronchial hypersecretion, premature puberty. The sharp withdrawal of the drug develops withdrawal syndrome.
Clonazepam cannot be used in myasthenia gravis, respiratory depression, acute alcohol intoxication, severe forms of COPD, severe depression, acute respiratory failure, coma, angle-closure glaucoma, poisoning with sleeping pills and narcotic analgesics, shock. The drug is contraindicated in case of allergy to the components of dosage forms. Clonazepam is forbidden to use for the treatment of premature and newborn children.
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