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Not to be confused with clozapine, clonazolam, or clorazolam.

Clonazepam
Clinical data
Pronunciationkləˈnazɪpam, kloe-NAZ-e-pam
Trade namesKlonopin, Rivotril, Paxam, [1] others [2]
AHFS/ Drugs.com Monograph
MedlinePlus a682279
License data
Pregnancy
category
Dependence
liability		 Physical: Very High Psychological: Moderate
Addiction
liability		Moderate [4] [5]
Routes of
administration		 By mouth, intramuscular, intravenous, sublingual
Drug class Benzodiazepine
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability90%
Protein binding≈85%
Metabolism Liver ( CYP3A) [11]
Metabolites7-aminoclonazepam
7-acetaminoclonazepam
3-hydroxy clonazepam [7] [8]
Onset of actionWithin an hour [9]
Elimination half-life19–60 hours [10]
Duration of action8–12 hours [9] [1]
Excretion Kidney
Identifiers
  • 5-(2-Chlorophenyl)-7-nitro-1,3-dihydro-1,4-benzodiazepin-2-one
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard ( EPA)
ECHA InfoCard 100.015.088 Edit this at Wikidata
Chemical and physical data
FormulaC15H10ClN3O3
Molar mass315.71 g·mol−1
3D model ( JSmol)
  • O=C1CN=C(c2ccccc2Cl)c2cc([N+](=O)[O-])ccc2N1
  • InChI=1S/C15H10ClN3O3/c16-12-4-2-1-3-10(12)15-11-7-9(19(21)22)5-6-13(11)18-14(20)8-17-15/h1-7H,8H2,(H,18,20) checkY
  • Key:DGBIGWXXNGSACT-UHFFFAOYSA-N checkY
   (verify)

Clonazepam, sold under the brand name Klonopin among others, is a benzodiazepine medication used to prevent and treat anxiety disorders, seizures, bipolar mania, agitation associated with psychosis, obsessive–compulsive disorder (OCD), and akathisia. [11] It is a long-acting [12] tranquilizer of the benzodiazepine class. [11] It possesses anxiolytic, anticonvulsant, sedative, hypnotic, and skeletal muscle relaxant properties. It is typically taken orally (swallowed by mouth) but is also used intravenously. [11] [13] Effects begin within one hour and last between eight and twelve hours in adults. [9] [1]

Common side effects may include sleepiness, weakness, poor coordination, difficulty concentrating, and agitation. Clonazepam may also decrease memory formation. [11] Long-term use may result in tolerance, dependence, and life-threatening withdrawal symptoms if stopped abruptly. [11] [14] Dependence occurs in one-third of people who take benzodiazepines for longer than four weeks. [10] The risk of suicide increases, particularly in people who are already depressed. [11] [15] Use during pregnancy may result in harm to the fetus. [11] Clonazepam binds to GABAA receptors, thus increasing the effect of the chief inhibitory neurotransmitter γ-aminobutyric acid (GABA). [10]

Clonazepam was patented in 1960 and went on sale in 1975 in the United States from Roche. [16] [17] It is available as a generic medication. [11] In 2022, it was the 57th most commonly prescribed medication in the United States, with more than 11 million prescriptions. [18] [19] In many areas of the world, it is commonly used as a recreational drug. [20] [21]

Medical uses

Clonazepam is prescribed for short-term management of epilepsy, anxiety, obsessive–compulsive disorder (OCD), and panic disorder with or without agoraphobia. [22] [23] [24]

Seizures

Clonazepam, like other benzodiazepines, while being a first-line treatment for acute seizures, is not suitable for the long-term treatment of seizures due to the development of tolerance to the anticonvulsant effects.

Clonazepam has been found effective in treating epilepsy in children, and the inhibition of seizure activity seemed to be achieved at low plasma levels of clonazepam. [25] As a result, clonazepam is sometimes used for certain rare childhood epilepsies, but it is ineffective in the control of infantile spasms. [26] Clonazepam is mainly prescribed for the acute management of epilepsy. Clonazepam is effective in the acute control of non-convulsive status epilepticus; the benefits, though, tended to be transient in many people, and the addition of phenytoin for lasting control was required in these patients. [27]

It is also approved for the treatment of typical and atypical absences (seizures) and infantile myoclonic and akinetic seizures. [28] A subgroup of people with treatment-resistant epilepsy may benefit from long-term use of clonazepam; the benzodiazepine clorazepate may be an alternative due to its slow onset of tolerance. [10] [29]

Anxiety disorders

The effectiveness of clonazepam in the short-term treatment of panic disorder has been demonstrated in controlled clinical trials. Some long-term trials have suggested a benefit of clonazepam for up to three years without the development of tolerance. [33] Clonazepam is also effective in the management of acute mania. [34]

Muscle disorders

Restless legs syndrome can be treated using clonazepam as a third-line treatment option, as the use of clonazepam is still investigational. [35] [36] Bruxism also responds to clonazepam in the short term. [37] REM sleep behavior disorder responds well to low doses of clonazepam. [38] It is also used for:

Other

  • Benzodiazepines, such as clonazepam, are sometimes used for the treatment of mania or acute psychosis-induced aggression. In this context, benzodiazepines are given either alone or in combination with other first-line drugs such as lithium, haloperidol, or risperidone. [42] [43] The effectiveness of taking benzodiazepines along with antipsychotic medication is unknown, and more research is needed to determine if benzodiazepines are more effective than antipsychotics when urgent sedation is required. [43]
  • Hyperekplexia [44]
  • Many forms of parasomnia and other sleep disorders are treated with clonazepam. [45]
  • It is not effective for preventing migraines. [46]

Contraindications

Adverse effects

In September 2020, the U.S. Food and Drug Administration (FDA) required the boxed warning be updated for all benzodiazepine medicines to describe the risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions consistently across all the medicines in the class. [48]

Common

Less common

  • Confusion [10]
  • Irritability and aggression [50]
  • Psychomotor agitation [51]
  • Lack of motivation [52]
  • Increased libido [53]
  • Loss of libido
  • Impaired motor function
    • Impaired coordination
    • Impaired balance
    • Dizziness
  • Cognitive impairments[ vague] [54]
  • Some users report hangover-like symptoms of drowsiness, headaches, sluggishness, and irritability upon waking up if the medication was taken before sleep. This is likely the result of the medication's long half-life, which continues to affect the user after waking up. [58] [59] [60] While benzodiazepines induce sleep, they tend to reduce the quality of sleep by suppressing or disrupting REM sleep. [61] After regular use, rebound insomnia may occur when discontinuing clonazepam. [62]
  • Benzodiazepines may cause or worsen depression. [10]

Occasional

Rare

The long-term effects of clonazepam can include depression, [10] disinhibition, and sexual dysfunction. [74]

Drowsiness

Clonazepam, like other benzodiazepines, may impair a person's ability to drive or operate machinery. The central nervous system depressing effects of the drug can be intensified by alcohol consumption, so alcohol should be avoided while taking this medication. Benzodiazepines have been shown to cause dependence. Patients dependent on clonazepam should be slowly titrated off under the supervision of a qualified healthcare professional to reduce the intensity of withdrawal or rebound symptoms.

  • Anxiety
  • Irritability
  • Insomnia
  • Tremors
  • Headaches
  • Stomach pain
  • Hallucinations
  • Suicidal thoughts or urges
  • Depression
  • Fatigue
  • Dizziness
  • Sweating
  • Confusion
  • Potential to exacerbate existing panic disorder upon discontinuation
  • Seizures [75] similar to delirium tremens (with long-term use of excessive doses)

Benzodiazepines such as clonazepam can be very effective in controlling status epilepticus, but, when used for longer periods of time, some potentially serious side-effects may develop, such as interference with cognitive functions and behavior. [76] Many individuals treated on a long-term basis develop a dependence. Physiological dependence was demonstrated by flumazenil-precipitated withdrawal. [77] Use of alcohol or other CNS depressants while taking clonazepam greatly intensifies the effects, including side effects, of the drug.

A recurrence of symptoms of the underlying disease should be separated from withdrawal symptoms. [78]

Tolerance and withdrawal

Main article: Benzodiazepine withdrawal syndrome

Like all benzodiazepines, clonazepam is a GABA-positive allosteric modulator. [79] [80] One-third of individuals treated with benzodiazepines for longer than four weeks develop a dependence on the drug and experience a withdrawal syndrome upon dose reduction. High dosage and long-term use increase the risk and severity of dependence and withdrawal symptoms. Withdrawal seizures and psychosis can occur in severe cases of withdrawal, and anxiety and insomnia can occur in less severe cases of withdrawal. A gradual reduction in dosage reduces the severity of the benzodiazepine withdrawal syndrome. Due to the risks of tolerance and withdrawal seizures, clonazepam is generally not recommended for the long-term management of epilepsies. Increasing the dose can overcome the effects of tolerance, but tolerance to the higher dose may occur and adverse effects may intensify. The mechanism of tolerance includes receptor desensitization, down regulation, receptor decoupling, and alterations in subunit composition and in gene transcription coding. [10]

Tolerance to the anticonvulsant effects of clonazepam occurs in both animals and humans. In humans, tolerance to the anticonvulsant effects of clonazepam occurs frequently. [81] [82] Chronic use of benzodiazepines can lead to the development of tolerance with a decrease of benzodiazepine binding sites. The degree of tolerance is more pronounced with clonazepam than with chlordiazepoxide. [83] In general, short-term therapy is more effective than long-term therapy with clonazepam for the treatment of epilepsy. [84] Many studies have found that tolerance develops to the anticonvulsant properties of clonazepam with chronic use, which limits its long-term effectiveness as an anticonvulsant. [28]

Abrupt or over-rapid withdrawal from clonazepam may result in the development of the benzodiazepine withdrawal syndrome, causing psychosis characterised by dysphoric manifestations, irritability, aggressiveness, anxiety, and hallucinations. [85] [86] [87] Sudden withdrawal may also induce the potentially life-threatening condition, status epilepticus. Anti-epileptic drugs, benzodiazepines such as clonazepam in particular, should be reduced in dose slowly and gradually when discontinuing the drug to mitigate withdrawal effects. [67] Carbamazepine has been tested in the treatment of clonazepam withdrawal but was found to be ineffective in preventing clonazepam withdrawal-induced status epilepticus from occurring. [88]

Overdose

Main article: Benzodiazepine overdose

Excess doses may result in:

Coma can be cyclic, with the individual alternating from a comatose state to a hyper-alert state of consciousness, which occurred in a four-year-old boy who overdosed on clonazepam. [89] The combination of clonazepam and certain barbiturates (for example, amobarbital), at prescribed doses has resulted in a synergistic potentiation of the effects of each drug, leading to serious respiratory depression. [90]

Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, and fainting. [91]

Detection in biological fluids

Clonazepam and 7-aminoclonazepam may be quantified in plasma, serum, or whole blood in order to monitor compliance in those receiving the drug therapeutically. Results from such tests can be used to confirm the diagnosis in potential poisoning victims or to assist in the forensic investigation in a case of fatal overdosage. Both the parent drug and 7-aminoclonazepam are unstable in biofluids, and therefore specimens should be preserved with sodium fluoride, stored at the lowest possible temperature and analyzed quickly to minimize losses. [92]

Special precautions

The elderly metabolize benzodiazepines more slowly than younger people and are also more sensitive to the effects of benzodiazepines, even at similar blood plasma levels. Doses for the elderly are recommended to be about half of that given to younger adults and are to be administered for no longer than two weeks. Long-acting benzodiazepines such as clonazepam are not generally recommended for the elderly due to the risk of drug accumulation. [10]

The elderly are especially susceptible to increased risk of harm from motor impairments and drug accumulation side effects. Benzodiazepines also require special precaution if used by individuals that may be pregnant, alcohol- or drug-dependent, or may have comorbid psychiatric disorders. [93] Clonazepam is generally not recommended for use in elderly people for insomnia due to its high potency relative to other benzodiazepines. [94]

Clonazepam is not recommended for use in those under 18. Use in very young children may be especially hazardous. Of anticonvulsant drugs, behavioural disturbances occur most frequently with clonazepam and phenobarbital. [93] [95]

Doses higher than 0.5–1 mg per day are associated with significant sedation. [96]

Clonazepam may aggravate hepatic porphyria. [97] [98]

Clonazepam is not recommended for patients with chronic schizophrenia. A 1982 double-blinded, placebo-controlled study found clonazepam increases violent behavior in individuals with chronic schizophrenia. [99]

Clonazepam has similar effectiveness to other benzodiazepines at often a lower dose. [100]

Interactions

Clonazepam decreases the levels of carbamazepine, [101] [102] and, likewise, clonazepam's level is reduced by carbamazepine. Azole antifungals, such as ketoconazole, may inhibit the metabolism of clonazepam. [10] Clonazepam may affect levels of phenytoin (diphenylhydantoin). [101] [103] [104] [105] In turn, Phenytoin may lower clonazepam plasma levels by increasing the speed of clonazepam clearance by approximately 50% and decreasing its half-life by 31%. [106] Clonazepam increases the levels of primidone [104] and phenobarbital. [107]

Combined use of clonazepam with certain antidepressants, anticonvulsants (such as phenobarbital, phenytoin, and carbamazepine), sedative antihistamines, opiates, and antipsychotics, nonbenzodiazepines (such as zolpidem), and alcohol may result in enhanced sedative effects. [10]

Pregnancy

See also: Long-term effects of benzodiazepines § Neonatal effects

There is some medical evidence of various malformations (for example, cardiac or facial deformations when used in early pregnancy); however, the data is not conclusive. The data are also inconclusive on whether benzodiazepines such as clonazepam cause developmental deficits or decreases in IQ in the developing fetus when taken by the mother during pregnancy. Clonazepam, when used late in pregnancy, may result in the development of a severe benzodiazepine withdrawal syndrome in the neonate. Withdrawal symptoms from benzodiazepines in the neonate may include hypotonia, apnoeic spells, cyanosis, and impaired metabolic responses to cold stress. [108]

The safety profile of clonazepam during pregnancy is less clear than that of other benzodiazepines, and if benzodiazepines are indicated during pregnancy, chlordiazepoxide and diazepam may be a safer choice. The use of clonazepam during pregnancy should only occur if the clinical benefits are believed to outweigh the clinical risks to the fetus. Caution is also required if clonazepam is used during breastfeeding. Possible adverse effects of use of benzodiazepines such as clonazepam during pregnancy include: miscarriage, malformation, intrauterine growth retardation, functional deficits, carcinogenesis, and mutagenesis. Neonatal withdrawal syndrome associated with benzodiazepines include hypertonia, hyperreflexia, restlessness, irritability, abnormal sleep patterns, inconsolable crying, tremors, or jerking of the extremities, bradycardia, cyanosis, suckling difficulties, apnea, risk of aspiration of feeds, diarrhea and vomiting, and growth retardation. This syndrome can develop between three days to three weeks after birth and can have a duration of up to several months. The pathway by which clonazepam is metabolized is usually impaired in newborns. If clonazepam is used during pregnancy or breastfeeding, it is recommended that serum levels of clonazepam are monitored and that signs of central nervous system depression and apnea are also checked for. In many cases, non-pharmacological treatments, such as relaxation therapy, psychotherapy, and avoidance of caffeine, can be an effective and safer alternative to the use of benzodiazepines for anxiety in pregnant women. [109]

Pharmacology

Mechanism of action

Clonazepam enhances the activity of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the central nervous system to give its anticonvulsant, skeletal muscle relaxant, and anxiolytic effects. [110] It acts by binding to the benzodiazepine site of the GABA receptors, which enhances the electric effect of GABA binding on neurons, resulting in an increased influx of chloride ions into the neurons. This further results in an inhibition of synaptic transmission across the central nervous system. [111] [112]

Benzodiazepines do not have any effect on the levels of GABA in the brain. [113] Clonazepam has no effect on GABA levels and has no effect on gamma-aminobutyric acid transaminase. Clonazepam does, however, affect glutamate decarboxylase activity. It differs from other anticonvulsant drugs it was compared to in a study. [114]

Clonazepam's primary mechanism of action is the modulation of GABA function in the brain, by the benzodiazepine receptor, located on GABAA receptors, which, in turn, leads to enhanced GABAergic inhibition of neuronal firing. Benzodiazepines do not replace GABA, but instead enhance the effect of GABA at the GABAA receptor by increasing the opening frequency of chloride ion channels, which leads to an increase in GABA's inhibitory effects and resultant central nervous system depression. [10] In addition, clonazepam decreases the utilization of 5-HT (serotonin) by neurons [115] [116] and has been shown to bind tightly to central-type benzodiazepine receptors. [117] Because clonazepam is effective in low milligram doses (0.5 mg clonazepam = 10 mg diazepam), [118] [119] it is said to be among the class of "highly potent" benzodiazepines. [120] The anticonvulsant properties of benzodiazepines are due to the enhancement of synaptic GABA responses, and the inhibition of sustained, high-frequency repetitive firing. [121]

Benzodiazepines, including clonazepam, bind to mouse glial cell membranes with high affinity. [122] [123] Clonazepam decreases release of acetylcholine in the feline brain [124] and decreases prolactin release in rats. [125] Benzodiazepines inhibit cold-induced thyroid-stimulating hormone (also known as TSH or thyrotropin) release. [126] Benzodiazepines act via micromolar benzodiazepine binding sites as Ca2+ channel blockers and significantly inhibit depolarization-sensitive calcium uptake in experimentation on rat brain cell components. This has been conjectured as a mechanism for high-dose effects on seizures in the study. [127]

Clonazepam is a 2'-chlorinated derivative of nitrazepam, which increases its potency due to electron-attracting effect of the halogen in the ortho-position. [128] [9]

Pharmacokinetics

Clonazepam is lipid-soluble, rapidly crosses the blood–brain barrier, and penetrates the placenta. It is extensively metabolised into pharmacologically inactive metabolites, with only 2% of the unchanged drug excreted in the urine. [129] Clonazepam is metabolized extensively via nitroreduction by cytochrome P450 enzymes, including CYP3A4. Erythromycin, clarithromycin, ritonavir, itraconazole, ketoconazole, nefazodone, cimetidine, and grapefruit juice are inhibitors of CYP3A4 and can affect the metabolism of benzodiazepines. [130] It has an elimination half-life of 19–60 hours. [10] Peak blood concentrations of 6.5–13.5 ng/mL were usually reached within 1–2 hours following a single 2 mg oral dose of micronized clonazepam in healthy adults. In some individuals, however, peak blood concentrations were reached at 4–8 hours. [131]

Clonazepam passes rapidly into the central nervous system, with levels in the brain corresponding with levels of unbound clonazepam in the blood serum. [132] Clonazepam plasma levels are very unreliable amongst patients. Plasma levels of clonazepam can vary as much as tenfold between different patients. [133]

Clonazepam has plasma protein binding of 85%. [134] [129] Clonazepam passes through the blood–brain barrier easily, with blood and brain levels corresponding equally with each other. [135] The metabolites of clonazepam include 7-aminoclonazepam, 7-acetaminoclonazepam and 3-hydroxy clonazepam. [7] [136] These metabolites are excreted by the kidney. [129]

It is effective for 6–8 hours in children, and 8–12 in adults. [137] [1]

Society and culture

Recreational use

See also: Benzodiazepine misuse

A 2006 US government study of hospital emergency department (ED) visits found that sedative-hypnotics were the most frequently implicated pharmaceutical drug in visits, with benzodiazepines accounting for the majority of these. Clonazepam was the second most frequently implicated benzodiazepine in ED visits. Alcohol alone was responsible for over twice as many ED visits as clonazepam in the same study. The study examined the number of times the non-medical use of certain drugs was implicated in an ED visit. The criteria for non-medical use in this study were purposefully broad, and include, for example, drug abuse, accidental or intentional overdose, or adverse reactions resulting from legitimate use of the medication. [138]

Formulations

Clonazepam was approved in the United States as a generic drug in 1997 and is now manufactured and marketed by several companies.

Clonazepam is available as tablets and orally disintegrating tablets (wafers) an oral solution (drops), and as a solution for injection or intravenous infusion. [139]

Crime

In some countries, clonazepam is used by criminals to subdue their victims. [140]

Brand names

Brand name clonazepam tablets

It is marketed under the brand name Rivotril by Roche in Argentina, Australia, Austria, Bangladesh, Belgium, Brazil, Canada, Colombia, Costa Rica, Croatia, the Czech Republic, Denmark, Estonia, [141] Germany, Hungary, Iceland, Ireland, Italy, China, Mexico, the Netherlands, Norway, Portugal, Peru, Pakistan, Romania, Serbia, South Africa, South Korea, Spain, Turkey, and the United States; Emcloz, Linotril, Lonazep, Clotrin and Clonotril in India and other parts of Europe; under the name Riklona in Indonesia and Malaysia; and under the brand name Klonopin by Roche in the United States. Other names, such as Antelepsin, Clonoten, Ravotril, Rivotril, Iktorivil, Clonex (Israel), Paxam, Petril, Naze, Zilepam and Kriadex, are used throughout the world. [2] [139] In August 2021, Roche Australia transferred Rivotril to Pharmaco Australia Ltd. [142]

  • Klonopin 0.5 mg tablet
    Klonopin 0.5 mg tablet
  • Klonopin 1 mg tablet
    Klonopin 1 mg tablet
  • Klonopin 2 mg tablet
    Klonopin 2 mg tablet
  • Clonazepam orally disintegrating tablet, 0.25 mg
    Clonazepam orally disintegrating tablet, 0.25 mg

References

  1. ^ a b c d "Paxam Data Sheet" (PDF). medsafe.govt.nz. 18 October 2023. Archived (PDF) from the original on 9 December 2023. Retrieved 14 March 2024.
  2. ^ a b "Clonazepam International". Drugs.com. Archived from the original on 25 August 2017.
  3. ^ "Clonazepam Use During Pregnancy". Drugs.com. 4 May 2020. Archived from the original on 28 July 2020. Retrieved 17 May 2020.
  4. ^ Longo LP, Johnson B (April 2000). "Addiction: Part I. Benzodiazepines--side effects, abuse risk and alternatives". American Family Physician. 61 (7): 2121–2128. PMID  10779253. Archived from the original on 12 May 2008. Retrieved 11 December 2022.
  5. ^ Hupp JR, Tucker MR, Ellis E (2013). Contemporary Oral and Maxillofacial Surgery - E-Book. Elsevier Health Sciences. p. 679. ISBN  9780323226875.
  6. ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
  7. ^ a b Ebel S, Schütz H (February 1977). "[Studies on the detection of clonazepam and its main metabolites considering in particular thin-layer chromatography discrimination of nitrazepam and its major metabolic products (author's transl)]". Arzneimittel-Forschung. 27 (2): 325–337. PMID  577149.
  8. ^ Steentoft A, Linnet K (January 2009). "Blood concentrations of clonazepam and 7-aminoclonazepam in forensic cases in Denmark for the period 2002-2007". Forensic Science International. 184 (1–3): 74–79. doi: 10.1016/j.forsciint.2008.12.004. PMID  19150586.
  9. ^ a b c d Cooper G, ed. (2007). Therapeutic uses of botulinum toxin. Totowa, N.J.: Humana Press. p. 214. ISBN  9781597452472. Archived from the original on 19 August 2016.
  10. ^ a b c d e f g h i j k l m n o Riss J, Cloyd J, Gates J, Collins S (August 2008). "Benzodiazepines in epilepsy: pharmacology and pharmacokinetics". Acta Neurologica Scandinavica. 118 (2): 69–86. doi: 10.1111/j.1600-0404.2008.01004.x. PMID  18384456. S2CID  24453988.
  11. ^ a b c d e f g h i "Clonazepam". The American Society of Health-System Pharmacists. Archived from the original on 5 September 2015. Retrieved 15 August 2015.
  12. ^ Basit H, Kahwaji CI (2024). "Clonazepam". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID  32310470. Retrieved 15 March 2024.
  13. ^ Koubeissi M (2016). "Intravenous Clonazepam in Status Epilepticus". Epilepsy Currents. 16 (2): 89–90. doi: 10.5698/1535-7511-16.2.89. PMC  4822737. PMID  27073337.
  14. ^ Edinoff AN, Nix CA, Hollier J, Sagrera CE, Delacroix BM, Abubakar T, et al. (November 2021). "Benzodiazepines: Uses, Dangers, and Clinical Considerations". Neurology International. 13 (4): 594–607. doi: 10.3390/neurolint13040059. PMC  8629021. PMID  34842811.
  15. ^ a b Dodds TJ (March 2017). "Prescribed Benzodiazepines and Suicide Risk: A Review of the Literature". The Primary Care Companion for CNS Disorders. 19 (2). doi: 10.4088/PCC.16r02037. PMID  28257172.
  16. ^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 535. ISBN  9783527607495. Archived from the original on 14 January 2023. Retrieved 28 July 2020.
  17. ^ Shorter E (2005). "B". A Historical Dictionary of Psychiatry. Oxford University Press. ISBN  9780190292010. Archived from the original on 2 October 2015.
  18. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  19. ^ "Clonazepam Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Archived from the original on 29 April 2017. Retrieved 30 August 2024.
  20. ^ Martino D, Cavanna AE, eds. (2013). Advances in the neurochemistry and neuropharmacology of Tourette Syndrome. Burlington: Elsevier Science. p. 357. ISBN  9780124115613. Archived from the original on 2 October 2015. In several countries, prescription and use is now severely limited due to abusive recreational use of clonazepam.
  21. ^ Fisher GL (2009). Encyclopedia of substance abuse prevention, treatment, & recovery. Los Angeles: SAGE. p. 100. ISBN  9781412950848. Archived from the original on 12 August 2016. frequently abused
  22. ^ Rossetti AO, Reichhart MD, Schaller MD, Despland PA, Bogousslavsky J (July 2004). "Propofol treatment of refractory status epilepticus: a study of 31 episodes". Epilepsia. 45 (7): 757–763. doi: 10.1111/j.0013-9580.2004.01904.x. PMID  15230698. S2CID  350479.
  23. ^ Ståhl Y, Persson A, Petters I, Rane A, Theorell K, Walson P (April 1983). "Kinetics of clonazepam in relation to electroencephalographic and clinical effects". Epilepsia. 24 (2): 225–231. doi: 10.1111/j.1528-1157.1983.tb04883.x. PMID  6403345. S2CID  2017627.
  24. ^ "Clonazepam: medicine to control seizures or fits, muscle spasms and restless legs syndrome". nhs.uk. 6 January 2020. Archived from the original on 28 July 2020. Retrieved 19 April 2020.
  25. ^ Dahlin MG, Amark PE, Nergårdh AR (January 2003). "Reduction of seizures with low-dose clonazepam in children with epilepsy". Pediatric Neurology. 28 (1): 48–52. doi: 10.1016/S0887-8994(02)00468-X. PMID  12657420.
  26. ^ Hrachovy RA, Frost JD, Kellaway P, Zion TE (October 1983). "Double-blind study of ACTH vs prednisone therapy in infantile spasms". The Journal of Pediatrics. 103 (4): 641–645. doi: 10.1016/S0022-3476(83)80606-4. PMID  6312008.
  27. ^ Tomson T, Svanborg E, Wedlund JE (May–June 1986). "Nonconvulsive status epilepticus: high incidence of complex partial status". Epilepsia. 27 (3): 276–285. doi: 10.1111/j.1528-1157.1986.tb03540.x. PMID  3698940. S2CID  26694857.
  28. ^ a b Browne TR (May 1976). "Clonazepam. A review of a new anticonvulsant drug". Archives of Neurology. 33 (5): 326–332. doi: 10.1001/archneur.1976.00500050012003. PMID  817697.
  29. ^ Song L, Liu F, Liu Y, Zhang R, Ji H, Jia Y (April 2020). "Clonazepam add-on therapy for drug-resistant epilepsy". The Cochrane Database of Systematic Reviews. 4 (4): CD012253. doi: 10.1002/14651858.CD012253.pub3. PMC  7168574. PMID  32309880.
  30. ^ Cloos JM (January 2005). "The treatment of panic disorder". Current Opinion in Psychiatry. 18 (1): 45–50. PMID  16639183. Archived from the original on 4 April 2011. Retrieved 25 September 2007.
  31. ^ Davidson JR, Potts N, Richichi E, Krishnan R, Ford SM, Smith R, et al. (December 1993). "Treatment of social phobia with clonazepam and placebo". Journal of Clinical Psychopharmacology. 13 (6): 423–428. doi: 10.1097/00004714-199312000-00008. PMID  8120156.
  32. ^ de Leon J (2 March 2012). A Practitioner's Guide to Prescribing Antiepileptics and Mood Stabilizers for Adults with Intellectual Disabilities. Springer Science & Business Media. ISBN  978-1-4614-2012-5.
  33. ^ Nardi AE, Freire RC, Mochcovitch MD, Amrein R, Levitan MN, King AL, et al. (February 2012). "A randomized, naturalistic, parallel-group study for the long-term treatment of panic disorder with clonazepam or paroxetine". Journal of Clinical Psychopharmacology. 32 (1): 120–126. doi: 10.1097/JCP.0b013e31823fe4bd. PMID  22198456. S2CID  801184.
  34. ^ Nardi AE, Perna G (May 2006). "Clonazepam in the treatment of psychiatric disorders: an update". International Clinical Psychopharmacology. 21 (3): 131–142. doi: 10.1097/01.yic.0000194379.65460.a6. PMID  16528135. S2CID  29469943.
  35. ^ "[Restless legs syndrome: diagnosis and treatment. Opinion of Brazilian experts]" [Restless legs syndrome: diagnosis and treatment. Opinion of Brazilian experts]. Arquivos de Neuro-Psiquiatria (in Portuguese). 65 (3A): 721–727. September 2007. doi: 10.1590/S0004-282X2007000400035. hdl: 11449/69841. PMID  17876423.
  36. ^ Trenkwalder C, Hening WA, Montagna P, Oertel WH, Allen RP, Walters AS, et al. (December 2008). "Treatment of restless legs syndrome: an evidence-based review and implications for clinical practice" (PDF). Movement Disorders. 23 (16): 2267–2302. doi: 10.1002/mds.22254. PMID  18925578. S2CID  91440. Archived from the original (PDF) on 29 December 2009. Retrieved 19 January 2010.
  37. ^ Huynh NT, Rompré PH, Montplaisir JY, Manzini C, Okura K, Lavigne GJ (2006). "Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size". The International Journal of Prosthodontics. 19 (5): 435–441. PMID  17323720.
  38. ^ Ferini-Strambi L, Zucconi M (September 2000). "REM sleep behavior disorder". Clinical Neurophysiology. 111 (Suppl 2): S136–S140. doi: 10.1016/S1388-2457(00)00414-4. PMID  10996567. S2CID  43692512.
  39. ^ Nelson DE (October 2001). "Akathisia--a brief review". Scottish Medical Journal. 46 (5): 133–134. doi: 10.1177/003693300104600502. PMID  11771491. S2CID  45721265. Archived from the original on 23 March 2009. Retrieved 1 March 2009.
  40. ^ Horiguchi J, Nishimatsu O, Inami Y (July 1989). "Successful treatment with clonazepam for neuroleptic-induced akathisia". Acta Psychiatrica Scandinavica. 80 (1): 106–107. doi: 10.1111/j.1600-0447.1989.tb01308.x. PMID  2569804. S2CID  27621771.
  41. ^ Lipton SA, Rosenberg PA (March 1994). "Excitatory amino acids as a final common pathway for neurologic disorders". The New England Journal of Medicine. 330 (9): 613–622. doi: 10.1056/NEJM199403033300907. PMID  7905600.
  42. ^ Curtin F, Schulz P (March 2004). "Clonazepam and lorazepam in acute mania: a Bayesian meta-analysis". Journal of Affective Disorders. 78 (3): 201–208. doi: 10.1016/S0165-0327(02)00317-8. PMID  15013244.
  43. ^ a b Gillies D, Sampson S, Beck A, Rathbone J (April 2013). "Benzodiazepines for psychosis-induced aggression or agitation". The Cochrane Database of Systematic Reviews. 4 (4): CD003079. doi: 10.1002/14651858.CD003079.pub3. hdl: 10454/16512. PMID  23633309.
  44. ^ Zhou L, Chillag KL, Nigro MA (October 2002). "Hyperekplexia: a treatable neurogenetic disease". Brain & Development. 24 (7): 669–674. doi: 10.1016/S0387-7604(02)00095-5. PMID  12427512. S2CID  40864297.
  45. ^ Schenck CH, Arnulf I, Mahowald MW (June 2007). "Sleep and sex: what can go wrong? A review of the literature on sleep related disorders and abnormal sexual behaviors and experiences". Sleep. 30 (6): 683–702. doi: 10.1093/sleep/30.6.683. PMC  1978350. PMID  17580590.
  46. ^ Mulleners WM, Chronicle EP (June 2008). "Anticonvulsants in migraine prophylaxis: a Cochrane review". Cephalalgia. 28 (6): 585–597. doi: 10.1111/j.1468-2982.2008.01571.x. PMID  18454787. S2CID  24233098.
  47. ^ Joint Formulary Committee. "British National Formulary (online)". London: BMJ Group and Pharmaceutical Press. Archived from the original on 10 June 2021. Retrieved 2 February 2020.
  48. ^ "FDA expands Boxed Warning to improve safe use of benzodiazepine drug". U.S. Food and Drug Administration (FDA). 23 September 2020. Archived from the original on 24 September 2020. Retrieved 23 September 2020. Public Domain This article incorporates text from this source, which is in the public domain.
  49. ^ Stacy M (2002). "Sleep disorders in Parkinson's disease: epidemiology and management". Drugs & Aging. 19 (10): 733–739. doi: 10.2165/00002512-200219100-00002. PMID  12390050. S2CID  40376995.
  50. ^ Lander CM, Donnan GA, Bladin PF, Vajda FJ (1979). "Some aspects of the clinical use of clonazepam in refractory epilepsy". Clinical and Experimental Neurology. 16: 325–332. PMID  121707.
  51. ^ Sorel L, Mechler L, Harmant J (1981). "Comparative trial of intravenous lorazepam and clonazepam im status epilepticus". Clinical Therapeutics. 4 (4): 326–336. PMID  6120763.
  52. ^ Wollman M, Lavie P, Peled R (1985). "A hypernychthemeral sleep-wake syndrome: a treatment attempt". Chronobiology International. 2 (4): 277–280. doi: 10.3109/07420528509055890. PMID  3870855.
  53. ^ "PAXAM DATA SHEET" (PDF). Archived (PDF) from the original on 9 December 2023. Retrieved 9 December 2023.
  54. ^ Aronson JK (20 November 2008). Meyler's Side Effects of Psychiatric Drugs (Meylers Side Effects). Elsevier Science. p. 403. ISBN  978-0-444-53266-4.
  55. ^ "Clonazepam Side Effects". Drugs.com. 2010. Archived from the original on 28 April 2010.
  56. ^ The interface of neurology internal medicine. Philadelphia: Wolters Kluwer Health/Lippincott Williams Wilkins. 1 September 2007. p. 963. ISBN  978-0-7817-7906-7.
  57. ^ The American Psychiatric Publishing Textbook of Psychopharmacology (Schatzberg, American Psychiatric Publishing Textbook of Psychopharmacology). USA: American Psychiatric Publishing, Inc. 31 July 2009. p. 471. ISBN  978-1-58562-309-9.
  58. ^ "Get Some Sleep: Beware the sleeping pill hangover". Archived from the original on 21 July 2017. Retrieved 21 June 2017.
  59. ^ Goswami M, Pandi-Perumal SR, Thorpy MJ (24 March 2010). Narcolepsy:: A Clinical Guide. Springer. p. 73. ISBN  978-1-4419-0853-7.
  60. ^ Kelsey JE, Newport DJ, Nemeroff CB (2006). Principles of psychopharmacology for mental health professionals. Hoboken, N.J.: Wiley-Liss. p. 269. ISBN  978-0-471-25401-0.
  61. ^ Lee-chiong T (24 April 2008). Sleep Medicine: Essentials and Review. Oxford University Press, USA. pp. 463–465. ISBN  978-0-19-530659-0.
  62. ^ Trevor AJ, Katzung BG, Masters SB (1 January 2008). Katzung Trevor's pharmacology: examination board review. New York: McGraw Hill Medical. p. 191. ISBN  978-0-07-148869-3. Archived from the original on 14 January 2023. Retrieved 28 July 2020.
  63. ^ Sjö O, Hvidberg EF, Naestoft J, Lund M (April 1975). "Pharmacokinetics and side-effects of clonazepam and its 7-amino-metabolite in man". European Journal of Clinical Pharmacology. 8 (3–4): 249–254. doi: 10.1007/BF00567123. PMID  1233220. S2CID  27095161.
  64. ^ Alvarez N, Hartford E, Doubt C (April 1981). "Epileptic seizures induced by clonazepam". Clinical EEG. 12 (2): 57–65. doi: 10.1177/155005948101200203. PMID  7237847. S2CID  39403793.
  65. ^ Ishizu T, Chikazawa S, Ikeda T, Suenaga E (July 1988). "[Multiple types of seizure induced by clonazepam in an epileptic patient]". No to Hattatsu = Brain and Development (in Japanese). 20 (4): 337–339. PMID  3214607.
  66. ^ Bang F, Birket-Smith E, Mikkelsen B (September 1976). "Clonazepam in the treatment of epilepsy. A clinical long-term follow-up study". Epilepsia. 17 (3): 321–324. doi: 10.1111/j.1528-1157.1976.tb03410.x. PMID  824124. S2CID  31409580.
  67. ^ a b Bruni J (April 1979). "Recent advances in drug therapy for epilepsy". Canadian Medical Association Journal (PDF). 120 (7): 817–824. PMC  1818965. PMID  371777.
  68. ^ Rosenfeld WE, Beniak TE, Lippmann SM, Loewenson RB (1987). "Adverse behavioral response to clonazepam as a function of Verbal IQ-Performance IQ discrepancy". Epilepsy Research. 1 (6): 347–356. doi: 10.1016/0920-1211(87)90059-3. PMID  3504409. S2CID  40893264.
  69. ^ White MC, Silverman JJ, Harbison JW (February 1982). "Psychosis associated with clonazepam therapy for blepharospasm". The Journal of Nervous and Mental Disease. 170 (2): 117–119. doi: 10.1097/00005053-198202000-00010. PMID  7057171.
  70. ^ Williams A, Gillespie M (July 1979). "Clonazepam-induced incontinence". Annals of Neurology. 6 (1): 86. doi: 10.1002/ana.410060127. PMID  507767. S2CID  36023934.
  71. ^ Sandyk R (August 1983). "Urinary incontinence associated with clonazepam therapy". South African Medical Journal = Suid-Afrikaanse Tydskrif vir Geneeskunde. 64 (7): 230. PMID  6879368.
  72. ^ Anders RJ, Wang E, Radhakrishnan J, Sharifi R, Lee M (October 1985). "Overflow urinary incontinence due to carbamazepine". The Journal of Urology. 134 (4): 758–759. doi: 10.1016/S0022-5347(17)47428-3. PMID  4032590.
  73. ^ van der Bijl P, Roelofse JA (May 1991). "Disinhibitory reactions to benzodiazepines: a review". Journal of Oral and Maxillofacial Surgery. 49 (5): 519–523. doi: 10.1016/0278-2391(91)90180-T. PMID  2019899.
  74. ^ Cohen LS, Rosenbaum JF (October 1987). "Clonazepam: new uses and potential problems". The Journal of Clinical Psychiatry. 48 (Suppl): 50–56. PMID  2889724.
  75. ^ Lockard JS, Levy RH, Congdon WC, DuCharme LL, Salonen LD (December 1979). "Clonazepam in a focal-motor monkey model: efficacy, tolerance, toxicity, withdrawal, and management". Epilepsia. 20 (6): 683–695. doi: 10.1111/j.1528-1157.1979.tb04852.x. PMID  115680. S2CID  31346286.
  76. ^ Vining EP (August 1986). "Use of barbiturates and benzodiazepines in treatment of epilepsy". Neurologic Clinics. 4 (3): 617–632. doi: 10.1016/S0733-8619(18)30966-6. PMID  3528811.
  77. ^ Bernik MA, Gorenstein C, Vieira Filho AH (1998). "Stressful reactions and panic attacks induced by flumazenil in chronic benzodiazepine users". Journal of Psychopharmacology. 12 (2): 146–150. doi: 10.1177/026988119801200205. PMID  9694026. S2CID  24348950.
  78. ^ Stahl SM (2014). Stahl's Essential Psychopharmacology: Prescriber's Guide (5th ed.). San Diego, CA: Cambridge University Press. p. 139. ISBN  978-1-107-67502-5.
  79. ^ Adjeroud S, Tonon MC, Leneveu E, Lamacz M, Danger JM, Gouteux L, et al. (May 1987). "The benzodiazepine agonist clonazepam potentiates the effects of gamma-aminobutyric acid on alpha-MSH release from neurointermediate lobes in vitro". Life Sciences. 40 (19): 1881–1887. doi: 10.1016/0024-3205(87)90046-4. PMID  3033417.
  80. ^ Yokota K, Tatebayashi H, Matsuo T, Shoge T, Motomura H, Matsuno T, et al. (March 2002). "The effects of neuroleptics on the GABA-induced Cl- current in rat dorsal root ganglion neurons: differences between some neuroleptics". British Journal of Pharmacology. 135 (6): 1547–1555. doi: 10.1038/sj.bjp.0704608. PMC  1573270. PMID  11906969.
  81. ^ Loiseau P (1983). "[Benzodiazepines in the treatment of epilepsy]". L'Encephale. 9 (4 Suppl 2): 287B–292B. PMID  6373234.
  82. ^ Scherkl R, Scheuler W, Frey HH (December 1985). "Anticonvulsant effect of clonazepam in the dog: development of tolerance and physical dependence". Archives Internationales de Pharmacodynamie et de Therapie. 278 (2): 249–260. PMID  4096613.
  83. ^ Crawley JN, Marangos PJ, Stivers J, Goodwin FK (January 1982). "Chronic clonazepam administration induces benzodiazepine receptor subsensitivity". Neuropharmacology. 21 (1): 85–89. doi: 10.1016/0028-3908(82)90216-7. PMID  6278355. S2CID  24771398.
  84. ^ Bacia T, Purska-Rowińska E, Okuszko S (1980). "Clonazepam in the treatment of drug-resistant epilepsy: a clinical short and long term follow-up study". Monographs in Neural Sciences. Frontiers of Neurology and Neuroscience. 5: 153–159. doi: 10.1159/000387498. ISBN  978-3-8055-0635-9. PMID  7033770.
  85. ^ Sironi VA, Miserocchi G, De Riu PL (April 1984). "Clonazepam withdrawal syndrome". Acta Neurologica. 6 (2): 134–139. PMID  6741654.
  86. ^ Sironi VA, Franzini A, Ravagnati L, Marossero F (August 1979). "Interictal acute psychoses in temporal lobe epilepsy during withdrawal of anticonvulsant therapy". Journal of Neurology, Neurosurgery, and Psychiatry. 42 (8): 724–730. doi: 10.1136/jnnp.42.8.724. PMC  490305. PMID  490178.
  87. ^ Jaffe R, Gibson E (June 1986). "Clonazepam withdrawal psychosis". Journal of Clinical Psychopharmacology. 6 (3): 193. doi: 10.1097/00004714-198606000-00021. PMID  3711371.
  88. ^ Sechi GP, Zoroddu G, Rosati G (September 1984). "Failure of carbamazepine to prevent clonazepam withdrawal status epilepticus". Italian Journal of Neurological Sciences. 5 (3): 285–287. doi: 10.1007/BF02043959. PMID  6500901. S2CID  23094043.
  89. ^ Welch TR, Rumack BH, Hammond K (1977). "Clonazepam overdose resulting in cyclic coma". Clinical Toxicology. 10 (4): 433–436. doi: 10.3109/15563657709046280. PMID  862377.
  90. ^ Honer WG, Rosenberg RG, Turey M, Fisher WA (November 1986). "Respiratory failure after clonazepam and amobarbital". The American Journal of Psychiatry. 143 (11): 1495b–1495. doi: 10.1176/ajp.143.11.1495b. PMID  3777263.
  91. ^ "Clonazepam, Prescription Marketed Drugs". Archived from the original on 25 April 2012.
  92. ^ R. Baselt, Disposition of Toxic Drugs and Chemicals in Man, 8th edition, Biomedical Publications, Foster City, CA, 2008, pp. 335-337.
  93. ^ a b Authier N, Balayssac D, Sautereau M, Zangarelli A, Courty P, Somogyi AA, et al. (November 2009). "Benzodiazepine dependence: focus on withdrawal syndrome". Annales Pharmaceutiques Françaises. 67 (6): 408–413. doi: 10.1016/j.pharma.2009.07.001. PMID  19900604.
  94. ^ Wolkove N, Elkholy O, Baltzan M, Palayew M (May 2007). "Sleep and aging: 2. Management of sleep disorders in older people". CMAJ. 176 (10): 1449–1454. doi: 10.1503/cmaj.070335. PMC  1863539. PMID  17485699.
  95. ^ Trimble MR, Cull C (1988). "Children of school age: the influence of antiepileptic drugs on behavior and intellect". Epilepsia. 29 (Suppl 3): S15–S19. doi: 10.1111/j.1528-1157.1988.tb05805.x. PMID  3066616. S2CID  20440040.
  96. ^ Hollister LE (1975). "Dose-ranging studies of clonazepam in man". Psychopharmacology Communications. 1 (1): 89–92. PMID  1223993.
  97. ^ Bonkowsky HL, Sinclair PR, Emery S, Sinclair JF (June 1980). "Seizure management in acute hepatic porphyria: risks of valproate and clonazepam". Neurology. 30 (6): 588–592. doi: 10.1212/WNL.30.6.588. PMID  6770287. S2CID  21137619.
  98. ^ Reynolds NC, Miska RM (April 1981). "Safety of anticonvulsants in hepatic porphyrias". Neurology. 31 (4): 480–484. doi: 10.1212/wnl.31.4.480. PMID  7194443. S2CID  40044726.
  99. ^ Karson CN, Weinberger DR, Bigelow L, Wyatt RJ (December 1982). "Clonazepam treatment of chronic schizophrenia: negative results in a double-blind, placebo-controlled trial". The American Journal of Psychiatry. 139 (12): 1627–1628. doi: 10.1176/ajp.139.12.1627. PMID  6756174.
  100. ^ "Benzodiazepine Equivalency Table: Benzodiazepine Equivalency". 28 April 2017. Archived from the original on 2 November 2017. Retrieved 19 February 2018.
  101. ^ a b Lander CM, Eadie MJ, Tyrer JH (1975). "Interactions between anticonvulsants". Proceedings of the Australian Association of Neurologists. 12: 111–116. PMID  2912.
  102. ^ Pippenger CE (1987). "Clinically significant carbamazepine drug interactions: an overview". Epilepsia. 28 (Suppl 3): S71–S76. doi: 10.1111/j.1528-1157.1987.tb05781.x. PMID  3319544. S2CID  22680377.
  103. ^ Saavedra IN, Aguilera LI, Faure E, Galdames DG (August 1985). "Phenytoin/clonazepam interaction". Therapeutic Drug Monitoring. 7 (4): 481–484. doi: 10.1097/00007691-198512000-00022. PMID  4082246.
  104. ^ a b Windorfer A, Sauer W (February 1977). "Drug interactions during anticonvulsant therapy in childhood: diphenylhydantoin, primidone, phenobarbitone, clonazepam, nitrazepam, carbamazepin and dipropylacetate". Neuropadiatrie. 8 (1): 29–41. doi: 10.1055/s-0028-1091502. PMID  321985. S2CID  9487285.
  105. ^ Windorfer A, Weinmann HM, Stünkel S (March 1977). "[Laboratory controls in long-term treatment with anticonvulsive drugs (author's transl)]". Monatsschrift Fur Kinderheilkunde. 125 (3): 122–128. PMID  323695.
  106. ^ Khoo KC, Mendels J, Rothbart M, Garland WA, Colburn WA, Min BH, et al. (September 1980). "Influence of phenytoin and phenobarbital on the disposition of a single oral dose of clonazepam". Clinical Pharmacology and Therapeutics. 28 (3): 368–375. doi: 10.1038/clpt.1980.175. PMID  7408397. S2CID  21980890.
  107. ^ Bendarzewska-Nawrocka B, Pietruszewska E, Stepień L, Bidziński J, Bacia T (1980). "[Relationship between blood serum luminal and diphenylhydantoin level and the results of treatment and other clinical data in drug-resistant epilepsy]". Neurologia I Neurochirurgia Polska. 14 (1): 39–45. PMID  7374896.
  108. ^ McElhatton PR (1994). "The effects of benzodiazepine use during pregnancy and lactation". Reproductive Toxicology. 8 (6): 461–475. Bibcode: 1994RepTx...8..461M. doi: 10.1016/0890-6238(94)90029-9. PMID  7881198.
  109. ^ Iqbal MM, Sobhan T, Ryals T (January 2002). "Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant". Psychiatric Services. 53 (1): 39–49. doi: 10.1176/appi.ps.53.1.39. PMID  11773648. Archived from the original on 11 July 2003.
  110. ^ "FDA clonazepam" (PDF). Archived (PDF) from the original on 5 October 2019. Retrieved 24 January 2019.
  111. ^ Skerritt JH, Johnston GA (May 1983). "Enhancement of GABA binding by benzodiazepines and related anxiolytics". European Journal of Pharmacology. 89 (3–4): 193–198. doi: 10.1016/0014-2999(83)90494-6. PMID  6135616.
  112. ^ Lehoullier PF, Ticku MK (March 1987). "Benzodiazepine and beta-carboline modulation of GABA-stimulated 36Cl-influx in cultured spinal cord neurons". European Journal of Pharmacology. 135 (2): 235–238. doi: 10.1016/0014-2999(87)90617-0. PMID  3034628.
  113. ^ Varotto M, Roman G, Battistin L (April 1981). "[Pharmacological influences on the brain level and transport of GABA. I) Effect of various antipileptic drugs on brain levels of GABA]". Bollettino della Societa Italiana di Biologia Sperimentale. 57 (8): 904–908. PMID  7272065.
  114. ^ Battistin L, Varotto M, Berlese G, Roman G (February 1984). "Effects of some anticonvulsant drugs on brain GABA level and GAD and GABA-T activities". Neurochemical Research. 9 (2): 225–231. doi: 10.1007/BF00964170. PMID  6429560. S2CID  34328063.
  115. ^ Meldrum BS (1986). "Drugs acting on amino acid neurotransmitters". Advances in Neurology. 43: 687–706. PMID  2868623.
  116. ^ Jenner P, Pratt JA, Marsden CD (1986). "Mechanism of action of clonazepam in myoclonus in relation to effects on GABA and 5-HT". Advances in Neurology. 43: 629–643. PMID  2418652.
  117. ^ Gavish M, Fares F (November 1985). "Solubilization of peripheral benzodiazepine-binding sites from rat kidney". The Journal of Neuroscience. 5 (11): 2889–2893. doi: 10.1523/JNEUROSCI.05-11-02889.1985. PMC  6565154. PMID  2997409.
  118. ^ "Benzodiazepine Equivalency Table" based on NRHA Drug Newsletter, April 1985 and Benzodiazepines: How they Work & How to Withdraw (The Ashton Manual), 2002. [1] Archived 29 July 2020 at the Wayback Machine
  119. ^ "What are the equivalent doses of oral benzodiazepines?". SPS - Specialist Pharmacy Service. Archived from the original on 26 July 2020. Retrieved 25 July 2020.
  120. ^ Chouinard G (2004). "Issues in the clinical use of benzodiazepines: potency, withdrawal, and rebound". The Journal of Clinical Psychiatry. 65 (Suppl 5): 7–12. PMID  15078112.
  121. ^ Macdonald RL, McLean MJ (1986). "Anticonvulsant drugs: mechanisms of action". Advances in Neurology. 44: 713–736. PMID  2871724.
  122. ^ Tardy M, Costa MF, Rolland B, Fages C, Gonnard P (April 1981). "Benzodiazepine receptors on primary cultures of mouse astrocytes". Journal of Neurochemistry. 36 (4): 1587–1589. doi: 10.1111/j.1471-4159.1981.tb00603.x. PMID  6267195. S2CID  34346051.
  123. ^ Gallager DW, Mallorga P, Oertel W, Henneberry R, Tallman J (February 1981). "[3H]Diazepam binding in mammalian central nervous system: a pharmacological characterization". The Journal of Neuroscience (PDF). 1 (2): 218–225. doi: 10.1523/JNEUROSCI.01-02-00218.1981. PMC  6564145. PMID  6267221.
  124. ^ Petkov V, Georgiev VP, Getova D, Petkov VV (1982). "Effects of some benzodiazepines on the acetylcholine release in the anterior horn of the lateral cerebral ventricle of the cat". Acta Physiologica et Pharmacologica Bulgarica. 8 (3): 59–66. PMID  6133407.
  125. ^ Grandison L (1982). "Suppression of prolactin secretion by benzodiazepines in vivo". Neuroendocrinology. 34 (5): 369–373. doi: 10.1159/000123330. PMID  6979001.
  126. ^ Camoratto AM, Grandison L (April 1983). "Inhibition of cold-induced TSH release by benzodiazepines". Brain Research. 265 (2): 339–343. doi: 10.1016/0006-8993(83)90353-0. PMID  6405978. S2CID  5520697.
  127. ^ Taft WC, DeLorenzo RJ (May 1984). "Micromolar-affinity benzodiazepine receptors regulate voltage-sensitive calcium channels in nerve terminal preparations". Proceedings of the National Academy of Sciences of the United States of America. 81 (10): 3118–3122. Bibcode: 1984PNAS...81.3118T. doi: 10.1073/pnas.81.10.3118. PMC  345232. PMID  6328498.
  128. ^ Shorvon S, Perucca E, Fish D, Dodson WE (2008). The Treatment of Epilepsy. John Wiley & Sons. p. 366. ISBN  9780470752456.
  129. ^ a b c "Clonazepam". www.drugbank.ca. Archived from the original on 25 January 2019. Retrieved 24 January 2019.
  130. ^ Dresser GK, Spence JD, Bailey DG (January 2000). "Pharmacokinetic-pharmacodynamic consequences and clinical relevance of cytochrome P450 3A4 inhibition". Clinical Pharmacokinetics. 38 (1): 41–57. doi: 10.2165/00003088-200038010-00003. PMID  10668858. S2CID  37743328.
  131. ^ "Monograph - Clonazepam -- Pharmacokinetics". Medscape. January 2006. Archived from the original on 28 August 2021. Retrieved 30 December 2007.
  132. ^ Parry GJ (1976). "An animal model for the study of drugs in the central nervous system". Proceedings of the Australian Association of Neurologists. 13: 83–88. PMID  1029011.
  133. ^ Gerna M, Morselli PL (January 1976). "A simple and sensitive gas chromatographic method for the determination of clonazepam in human plasma". Journal of Chromatography. 116 (2): 445–450. doi: 10.1016/S0021-9673(00)89915-X. PMID  1245581.
  134. ^ Tokola RA, Neuvonen PJ (1983). "Pharmacokinetics of antiepileptic drugs". Acta Neurologica Scandinavica. Supplementum. 97: 17–27. doi: 10.1111/j.1600-0404.1983.tb01532.x. PMID  6143468. S2CID  25137468.
  135. ^ Greenblatt DJ, Miller LG, Shader RI (October 1987). "Clonazepam pharmacokinetics, brain uptake, and receptor interactions". The Journal of Clinical Psychiatry. 48 (Suppl): 4–11. PMID  2822672.
  136. ^ Edelbroek PM, De Wolff FA (October 1978). "Improved micromethod for determination of underivatized clonazepam in serum by gas chromatography" (PDF). Clinical Chemistry (PDF). 24 (10): 1774–1777. doi: 10.1093/clinchem/24.10.1774. PMID  699288. Archived (PDF) from the original on 7 June 2011.
  137. ^ Cooper G (5 October 2007). Therapeutic Uses of Botulinum Toxin. Springer. ISBN  9781597452472.
  138. ^ "Drug Abuse Warning Network, 2006: National Estimates of Drug-Related Emergency Department Visits". Substance Abuse and Mental Health Services Administration. 2006. Archived from the original on 16 March 2014. Retrieved 9 February 2009.
  139. ^ a b Buckingham R (ed.). "Clonazepam". Martindale: The Complete Drug Reference. London: Pharmaceutical Press. Archived from the original on 10 June 2021. Retrieved 18 January 2019.
  140. ^ Carabajal G (8 December 2022). "Burundanga y Clonazepan. El cóctel de pastillas que usaba una "viuda negra" para doblegar a sus incautos pretendientes" [Burundanga and Clonazepan. The cocktail of pills that a "black widow" used to subdue her unwary suitors]. La Nacion [The Nation] (in Spanish). Archived from the original on 9 December 2022. Retrieved 9 December 2022.
  141. ^ "Register of Medicinal Products". ravimiregister.ravimiamet.ee. Archived from the original on 28 August 2021. Retrieved 18 January 2019.
  142. ^ "Rivotril". NPS MedicineWise. 13 November 2020. Archived from the original on 7 March 2023. Retrieved 9 January 2023.

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