Name: Clonazepam (Clonopin)
Class: Benzodiazepine (Antiepileptic: Absence)
Mechanism: Acts on BZD receptors closely coupled to GABAA receptors ® enhancement of GABA inhib. action via freq. of Cl- channel opening.
Absorption:
Dist.: Metabolism.: Excretion, t½:
Toxicity/S.E.s: All dose-related. Acute—excessive depression of CNS fxns (drowsiness, sleep, confusion, disorientation, ataxia, slurred speech, nystagmus, mild amnesia, dementia). May also cause aggression, hyperactivity, delirium, insomnia. Large doses or mixture w/depressants (e.g., EtOH) may cause resp. depression, coma, hallucinations, nightmares, confusion. Chronic—impaired thinking/memory, weight gain/loss. Habituation & physical dependence ® w/drawal syndrome. Abrupt discontinuation ® risk for convulsion. Metabolism. ¯ in elderly and by cimetidine. Overdose ® serious resp. depression (rarely fatal w/support). Development of tolerance.
Utility: Alt. to ethosuximide and valproate for uncomp. absence. Alt. to valproate for atypical absence. Limited use due to development of tolerance.
Special Features: