Excitability clonazepam

Benzodiazepines are the drugs of choice for status epilepticus (see above) however, development of tolerance renders them less suitable for long-term therapy. Clonazepam is used for myoclonic and atonic seizures. Clobazam, a 1,5-benzodiazepine exhibiting an increased anticonvulsant/seda-tive activity ratio, has a similar range of clinical uses. Personality changes and paradoxical excitement are potential side effects. 

A 28-year-old man received interferon alfa (5 MU/day for 28 days) for chronic hepatitis B. At the end of treatment he developed a slight parkinsonian gait, and 8 days later had a fever with vomiting, insomnia, restlessness, and raised serum creatine kinase activity (4946 IU/1). He had severe akathisia with psychomotor excitement and parkinsonism. Despite treatment with clonazepam, thioridazine, propranolol, trihexyphenidyl, and bromocriptine, his condition progressively worsened. He was finally given intravenous levodopa for 8 days and recovered dramatically within the next few days. 

With Klonopin (clonazepam), the most common side effects are difficulty with balance and drowsiness PDR, 2(XX)). Social workers need to be aware that there may be behavioral and emotional side effects that include irritability, excitement, increased anger and aggression, trouble sleeping or nightmares, and memory loss (Dulcan, 1999). These side effects can be very disturbing to the client as well as to family members, and it is critical that families be educated about the problems that can occur and how to handle them. The most serious side effect with Klonopin is probably the interaction if this medication is combined with alcohol or other drugs, which can result in sleepiness, unconsciousness, and death PDR, 2000). 

Benzodiazepines help the brain s calming chemicals (GABA) make the brain s pathways less excitable, e.g. diazepam, lorazepam, clonazepam... 

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