Klonopin for Anxiety: What You Need to Know

Klonopin (clonazepam) is a benzodiazepine medication approved to treat seizure and panic disorders. It's also sometimes used for other mental health disorders that involve feelings of anxiousness, such as being a second-line treatment for social anxiety disorder (SAD).

If you've been prescribed Klonopin for anxiety, it's helpful to understand how this medication works. It's also important to know Klonopin's risks, precautions, warnings, and potential drug interactions so you know how to use this drug safely—and to determine if it's the right anxiety treatment for you. Here we cover all of these and more.

How Klonopin Treats Anxiety

Benzodiazepines such as Klonopin slow electrical activity in the brain. This slowed activity helps ease feelings of anxiousness.

It's not clear exactly how Klonopin reduces panic, but its effects are thought to be related to the activation of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Benzodiazepines calm the brain by binding to GABA receptors.

In the treatment of SAD, benzodiazepines are often taken with an antidepressant such as a selective serotonin reuptake inhibitor (SSRI). These antidepressants are considered first-line treatments for SAD. However, Klonopin may be added if the person hasn't responded well to an SSRI alone.

Since it acts quickly, Klonopin can be used when needed, like when performance anxiety hits, before giving a big presentation, or meeting a lot of new people. Because anti-anxiety medications such as benzodiazepines run the risk of dependence, they may only be prescribed short term.

Klonopin Dosage

Klonopin comes in tablet form, some of which are orally disintegrating, and available in strengths of 0.5 mg, 1 mg, and 2 mg. A low dose is typically prescribed at first. If this doesn't relieve symptoms sufficiently, the dosage may be increased. Because benzodiazepines can be habit-forming, Klonopin is usually a short-term treatment.

Who Shouldn't Take Klonopin

People with certain medical conditions or in specific circumstances that affect their health might not be able to take Klonopin or need to take precautions. This makes it important to tell your care provider about your medical history and work with them to find an anxiety treatment that's right for you.

Klonopin is not recommended for people who:

• Have a sensitivity to benzodiazepines (such as Ativan, Xanax, or Valium)
• Have significant liver disease
• Have been diagnosed with acute narrow-angle glaucoma

Precautions should be taken if you've been prescribed Klonopin and:

• Have a respiratory disease or any lung issues
• Have depression or a history of depression
• Have suicidal thoughts or behaviors, or you've had them in the past
• Are pregnant or planning to become pregnant, or are breastfeeding or planning to start
• Have any kidney or liver issues
• Have been diagnosed with porphyria
• Are younger than 18 or older than 64

Klonopin Side Effects

Some people experience side effects when taking Klonopin. Some Klonopin side effects are common and mild. Others are more severe, requiring medical attention.

Common Side Effects

The most common adverse effects when taking Klonopin include:

• Dizziness
• Drowsiness or fatigue
• Feeling lightheaded
• Trouble concentrating
• Impaired coordination

These effects will often go away within a couple of weeks of starting the drug. If they don't go away or become bothersome, tell your healthcare provider. They may adjust your dosage to relieve the effects or switch you to a different anti-anxiety medication.

When you first start taking Klonopin, avoid activities that could be dangerous to you or others until you have adjusted to the medication. Wait until you know how you feel after taking it and how it affects you before you drive, operate heavy machinery, or participate in potentially hazardous activities.

People who are older might be more likely to experience medication side effects, including those that commonly occur with benzodiazepine use. Older people also have an increased risk of falling and negative cognitive effects.

Never stop taking Klonopin abruptly without talking to your care provider, even if you are experiencing side effects. This is because suddenly stopping this medication can worsen your condition or lead to withdrawal symptoms.

Severe Side Effects

Some potential side effects of Klonopin are serious—even life-threatening. If you take Klonopin with alcohol, illicit drugs, or certain other medications (such as opioid painkillers), it increases your risk of serious side effects.

If someone taking Klonopin exhibits the following symptoms, seek immediate medical care:

• Extreme sleepiness, loss of consciousness, or unresponsiveness. These can be signs that someone has taken too much Klonopin or mixed it with another medication or substance that is causing a reaction.
• Trouble breathing, rashes, hives, and swelling of the face, throat, and eyes. These can be signs of an allergic reaction.

While not common, Klonopin can also cause suicidal thoughts and ideations. Contact your care provider immediately if you experience any changes in your behavior or mood, such as:

• Problems sleeping or insomnia
• New or worsening anxiety or depression
• Thinking about dying

Warnings and Interactions for Klonopin

Before taking Klonopin, it's important to be aware of its risks. Here are some to consider.

Risk of Addition and Misuse

One risk associated with Klonopin is its potential for addiction and misuse, which is why it's classified as a controlled substance. This can lead to overdose and even death—particularly when other substances are used at the same time, such as opioids or alcohol.

There is also a risk of dependence when taking Klonopin. Taking the medication daily for longer than two weeks increases your risk of physical dependence.

Due to this dependence, stopping Klonopin suddenly can cause withdrawal symptoms, such as seizures, which can be life-threatening. If you want to reduce or stop your dose, talk to your care provider. They can reduce your dosage slowly over time, an approach known as tapering.

Drug Interactions

If you take other medications besides Klonopin, you should be aware of how these medications could affect one another. There are several types, or classes, of prescription drugs that should be used with significant caution when combined with Klonopin. These include:

• Antipsychotic agents (thioxanthene and butyrophenone classes)
• Barbiturates and nonbarbiturate hypnotics
• Narcotics
• Other anti-anxiety drugs
• Phenothiazines (such as Thorazine)

Some prescription medications can change how much Klonopin is in your body, as well as how well the drug works. Medications that may increase the levels and effects of Klonopin include:

• Ketoconazole
• Luvox (fluvoxamine)
  
• Sporanox (itraconazole)
• Nefazodone

Medications that can decrease the levels and effects of Klonopin include:

• Dilantin (phenytoin)
• Phenobarbital
• Tegretol (carbamazepine)

Some people with anxiety disorders also take an antidepressant. You should know that monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs) can enhance the depressant or sedative effects of Klonopin.

OTC Medications and Supplements

Additionally, some over-the-counter products, herbs, and supplements are not safe to take with Klonopin. That's why it's important to tell your physician and/or pharmacist about all medications and substances you use. This includes:

• Antihistamines
• Cold, cough, and flu symptom relief remedies, especially those that contain certain ingredients, such as dextromethorphan
• Kava kava
• Magnesium sulfate (Epsom salts)
• Proton pump inhibitors (PPIs)
• St. John's wort
• Sleep aids, including alternative remedies that contain valerian
• Tagamet HB (cimetidine)

Drinking grapefruit juice may also pose a risk because grapefruit contains compounds that can change how certain medications work. You might not have to give it up completely, but you might be advised to limit how much you have. Ask your physician if you should avoid it while taking Klonopin.

Proper Disposal of Klonopin

If you have some of this medication that you no longer need, it's important to dispose of it properly. Prescription medications cannot necessarily be tossed in your trash or flushed down the drain.

When medications are disposed of improperly, they can harm people, animals, and the environment. For example, drugs that are flushed down the toilet end up in the local water supply, and when medications are thrown out in the garbage, they could find their way to a person who would be harmed by taking them or end up on the street where they could be sold illegally.

To help prevent these outcomes, many hospitals, clinics, pharmacies, and other community organizations offer take-back programs for unused or expired medications. If your physician has not given you instructions about what to do with unused Klonopin, ask a pharmacist. They can tell you how to properly dispose of unused medications.

Summary

If you are prescribed Klonopin for anxiety, your physician has decided that this medicine's benefits outweigh the risks. If you don't feel that Klonopin is helping you with your symptoms or are experiencing intolerable side effects, there are other medications and treatment options you can try.

In addition to medication, your care provider might recommend engaging in therapy to help ease your anxiety. For example, cognitive behavioral therapy (CBT), during which you work with a therapist to learn how to change your thought patterns and behaviors to better handle anxiety-provoking situations, has been found effective for people with anxiety disorders.