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Clonazepam

Indications, Side Effects, and Potential for Nonmedical Use

Dokkedal-Silva, Vinícius MSc; Berro, Laís Fernanda PhD; Galduróz, José Carlos Fernandes PhD; Tufik, Sergio MD, PhD; Andersen, Monica Levy PhD

doi: 10.1097/HRP.0000000000000227
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Learning objectives After participating in this activity, learners should be better able to:

• Assess the misuse potential of clonazepam

• Characterize the nonmedical use of clonazepam

• Identify the health problems associated with long-term use of clonazepam

Clonazepam, a benzodiazepine, is commonly used in treating various conditions, including anxiety disorders and epileptic seizures. Due to its low price and easy availability, however, it has become a commonly misused medication, both in medical and recreational contexts. In this review, we aim to highlight the behavioral and pharmacological aspects of clonazepam and its history following its approval for human use. We examine the circumstances commonly associated with the nonmedical use of clonazepam and raise points of particular concern. Clonazepam, alone or in combination with other psychoactive substances, can lead to unwanted effects on health, such as motor and cognitive impairment, sleep disorders, and aggravation of mood and anxiety disorders. Prolonged use of clonazepam may lead to physical dependence and tolerance. There is therefore a need to find safer therapeutic alternatives for treating seizures and anxiety disorders. Greater awareness of its frequent nonmedical use is also needed to achieve safer overall use of this medication.

From Departamento de Psicobiologia, Universidade Federal de São Paulo (Mr. Dokkedal-Silva and Drs. Galduróz, Tufik, and Andersen) (Brazil); Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS (Dr. Berro).

Supported by grants from the Associação Fundo de Incentivo à Pesquisa; by grant no. 133397/2017-3 received from, and by fellowships awarded by (Drs. Galduróz, Tufik, and Andersen), the National Council for Scientific and Technological Development.

Original manuscript received 30 July 2018; revised manuscript received 4 December 2018, accepted for publication subject to revision 14 January 2019; revised manuscript received 6 February 2019.

Correspondence: Monica Levy Andersen, Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 925, São Paulo, 04024-002, Brazil. Email: ml.andersen12@gmail.com

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Online date: August 5, 2019

© 2019 President and Fellows of Harvard College
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