Medications for REM Sleep Behavior Disorder
Clonazepam (Klonopin) is highly effective in the treatment of REM sleep behavior disorder (RBD), relieving symptoms in nearly 90% of patients with little evidence of tolerance or abuse. The response usually begins within the first week, often on the first night.
The initial dose is 0.5 mg at bedtime, with some persons requiring a rapid increase to 1 mg. After years of continued treatment, moderate limb twitching with sleep talking and more complex behaviors can reemerge. The treatment should be continued for as long as your doctor says. If you decide to stop, the medicine should be slowly tapered, watching for signs of withdrawal such as nightmares or agitation.
Other drugs, such as tricyclic antidepressants, may be effective in some persons with RBD. However, tricyclics are also known to precipitate RBD in some patients.
The hormone melatonin is also often used to treat sleep disorders.
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Clonazepam (Klonopin) is highly effective in the treatment of REM sleep behavior disorder (RBD), relieving symptoms in nearly 90% of patients with little evidence of tolerance or abuse. The response usually begins within the first week, often on the first night.
The initial dose is 0.5 mg at bedtime, with some persons requiring a rapid increase to 1 mg. After years of continued treatment, moderate limb twitching with sleep talking and more complex behaviors can reemerge. The treatment should be continued for as long as your doctor says. If you decide to stop, the medicine should be slowly tapered, watching for signs of withdrawal such as nightmares or agitation.
Other drugs, such as tricyclic antidepressants, may be effective in some persons with RBD. However, tricyclics are also known to precipitate RBD in some patients.
The hormone melatonin is also often used to treat sleep disorders.
Clonazepam
Generic name: clonazepam [ kloe-NAZ-e-pam ]
Brand names: KlonoPIN, KlonoPIN Wafer
Dosage forms: oral tablet (0.5 mg; 1 mg; 2 mg), oral tablet, disintegrating (0.125 mg; 0.25 mg; 0.5 mg; 1 mg; 2 mg)
Drug classes: Benzodiazepine anticonvulsants, Benzodiazepines
What is clonazepam?
Clonazepam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). It is thought that benzodiazepines work by enhancing the activity of certain neurotransmitters in the brain.
Clonazepam is used to treat certain seizure disorders (including absence seizures or Lennox-Gastaut syndrome) in adults and children.
Clonazepam is also used to treat panic disorder (including agoraphobia) in adults.
Warnings
Clonazepam can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other drugs that can slow your breathing.
MISUSE OF CLONAZEPAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Never share clonazepam with another person. Selling or giving away this medicine is against the law.
Some people have thoughts about suicide while taking clonazepam. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide.
Get medical help right away if you stop using clonazepam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide.
Do not stop using clonazepam without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer.
Before taking this medicine
You should not take clonazepam if you allergic to it or if you have:
narrow-angle glaucoma;
severe liver disease; or
a history of allergic reaction to any benzodiazepine (including alprazolam, diazepam, lorazepam, Valium, Xanax, Versed, and others).
To make sure this medicine is safe for you, tell your doctor if you have ever had:
kidney or liver disease;
breathing problems;
depression, mood problems, or suicidal thoughts or behavior; or
porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system).
Some people have thoughts about suicide while taking clonazepam. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.
Tell your doctor if you are pregnant or plan to become pregnant. If you use clonazepam during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.
Do not start or stop seizure medication during pregnancy without your doctor's advice. Clonazepam may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Preventing seizures may outweigh these risks. Tell your doctor right away if you become pregnant.
Ask a doctor if it is safe to breastfeed while using this medicine.
Do not give this medicine to a child without medical advice. Clonazepam is not approved to treat panic disorder in anyone younger than 18 years old.
How should I take clonazepam?
Take clonazepam exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Never use this medicine in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of this medicine.
Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
You will need frequent medical tests.
Do not stop using clonazepam suddenly, even if you feel fine. Stopping suddenly may cause increased seizures or unpleasant withdrawal symptoms. Follow your doctor's instructions about tapering your dose.
Swallow the regular tablet whole, with a full glass of water.
Clonazepam doses are based on weight in children. Your child's dose needs may change if the child gains or loses weight.
Remove an orally disintegrating tablet from the package only when you are ready to take the medicine. Place the tablet in your mouth and allow it to dissolve, without chewing. Swallow several times as the tablet dissolves.
Your doctor will need to check your progress on a regular basis.
Call your doctor if this medicine seems to stop working as well in treating your seizures or panic attacks.
Seizures are often treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.
Store at room temperature away from moisture, heat, and light. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of clonazepam can be fatal if you take it with alcohol, opioid medicine, or other drugs that cause drowsiness or slow your breathing.
Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, or coma.
What should I avoid while taking clonazepam?
Do not drink alcohol. Dangerous side effects or death could occur.
Avoid driving or hazardous activity until you know how clonazepam will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.
Clonazepam side effects
Get emergency medical help if you have signs of an allergic reaction to clonazepam: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Clonazepam can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.
Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
new or worsening seizures;
severe drowsiness;
weak or shallow breathing;
unusual changes in mood or behavior;
confusion, paranoia, nightmares, hallucinations;
thoughts of suicide or hurting yourself;
unusual or involuntary eye movements.
Drowsiness or dizziness may last longer in older adults. Use caution to avoid falling or accidental injury.
Common clonazepam side effects may include:
drowsiness, dizziness;
feeling tired or depressed;
memory problems; or
problems with walking or coordination.
After you stop using clonazepam, get medical help right away if you have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, suicidal thoughts or actions.
Some withdrawal symptoms may last up to 12 months or longer after stopping this medicine suddenly. Tell your doctor if you have ongoing anxiety, depression, problems with memory or thinking, trouble sleeping, ringing in your ears, a burning or prickly feeling, or a crawling sensation under your skin.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Related/similar drugs
What other drugs will affect clonazepam?
Using clonazepam with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
Other drugs may interact with clonazepam, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.
Popular FAQ
Is clonazepam a controlled substance?
Clonazepam is a benzodiazepine prescription drug and is classified by the DEA as Schedule IV controlled substance under the federal Controlled Substances Act. Schedule IV drugs have a lower potential for abuse relative to drugs in Schedule III (for example, codeine or buprenorphine) but can still be abused. Abuse may lead to limited physical or psychological dependence. Continue reading
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