REVIEWClonazepam in the treatment of psychiatric disorders: an updateNardi, Antonio E.a; Perna, GiampaolobAuthor Information aInstitute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil bAnxiety Disorders Clinical and Research Unit, Vita-Salute University, Istituto Scientifico Ospedale San Raffaele, Milan, Italy Correspondence and requests for reprints to Professor Antonio Egidio Nardi, Institute of Psychiatry, Federal University of Rio de Janeiro, R. Visconde de Piraja, 407/702 Rio de Janeiro, RJ 22410-003, Brazil Tel: +55 21 25216147; fax: +55 21 25236839; e-mail: [email protected] Received 22 February 2005 Accepted 18 November 2005 International Clinical Psychopharmacology: May 2006 - Volume 21 - Issue 3 - p 131-142 doi: 10.1097/01.yic.0000194379.65460.a6 Buy Metrics Abstract An updated overview over the past decade is provided with respect to the use of clonazepam in a variety of psychiatric disorders. The efficacy of clonazepam monotherapy for the short-term treatment of panic disorder (PD) was fully established in two large pivotal multicentre studies in the late 1990s in a total of >800 patients. Other studies support a role for clonazepam, in association with selective serotonin reuptake inhibitors (SSRIs), to accelerate treatment response in PD. Although some longitudinal data suggest an ability to maintain improvement without tolerance for up to 3 years, long-term controlled studies of clonazepam in PD are lacking. Studies have shown that clonazepam can also block CO2-induced panic and improve certain aspects of quality of life in PD. Clonazepam has shown some efficacy in social phobia; however, because this evidence is based on few studies, further studies are warranted before definitive conclusions can be drawn. Finally, evidence for the use of clonazepam in acute mania and as augmentation therapy with SSRIs to accelerate response in depression is examined. The long half-life and higher potency of clonazepam may allow easier discontinuation with fewer withdrawal symptoms compared to other benzodiazepines and studies using a slow clonazepam taper appear promising. © 2006 Lippincott Williams & Wilkins, Inc.