Can You Take Klonopin For Life? Here’s What You Need To Know

Klonopin is an effective, short-term treatment for anxiety disorders, panic attacks, and seizure disorders. It is not considered a safe long-term treatment due to a lack of research on its long-term use, its risk for misuse, abuse, and addiction, and the possibility of long-term side effects. Before taking Klonopin, review the risks and benefits and discuss these with your healthcare provider.

Key Points

• Klonopin is the brand name of the drug clonazepam. It is FDA-approved to treat anxiety disorders and seizures.
• Klonopin is an effective short-term treatment, but there has been limited research on its long-term effectiveness and consequences.
• Klonopin has risks for misuse, abuse, and addiction. It is a CNS depressant and should not be used with other depressants due to the increased risk of overdose.

What Is Klonopin?

Klonopin is the brand name of the generic drug clonazepam.[1]  It is a benzodiazepine drug that has anticonvulsant and anxiolytic effects. It is FDA-approved to treat panic disorders and seizures.[2]  It is also used off-label to treat mania, restless leg syndrome, insomnia, and tardive dyskinesia (a chronic disorder that causes involuntary, repetitive movements in the face and body).

How Does Klonopin Work?

Klonopin is a long-acting, high-potency benzodiazepine.[3] It is rapidly absorbed after being taken orally and reaches its peak concentration in one to four hours. Its half-life is 30-40 hours, and excreted through urine.

Klonopin is a gamma-aminobutyric acid (GABA) receptor agonist that reduces neuron firing and calms the brain due to decreased neuron excitability. It also impacts serotonergic activity by increasing serotonin synthesis.

What Are Klonopin Side Effects?

Common side effects of Klonopin include [4]

• Lethargy
• Fatigue
• Sedation
• Drowsiness
• motor impairment (impaired coordination, impaired balance, dizziness)
• Blurred vision
• Confusion
• Irritability
• Loss of libido
• Lack of motivation
• Psychomotor agitation
• Hallucination
• Worsening of depression
• Short-term memory loss
• Difficulty forming new memories (especially with high doses)

Rare Klonopin side effects include [5]

• Personality changes
• Behavioral disturbance
• Loss of muscle coordination
• Increased frequency of seizures
• Thrombocytopenia
• Dysphoria
• Paradoxical disinhibition (excitement, rage, and impulsive behavior, seen more often in older persons taking Klonopin)
• Suicide
• Psychosis
• Incontinence

Benefits of Klonopin

Anxiety and Panic Disorders

Klonopin is an effective treatment plan for the short-term management of panic attacks and anxiety disorders.  The effects of Klonopin are felt within an hour of taking the medicine for a panic attack.

Studies reported that taking Klonopin for six weeks reduced panic attacks to one time a week or less, with over half the people reporting no panic attacks at all.[6] These studies focused on the short-term use of Klonopin for treating panic disorders over a six to nine-week period. The long-term effectiveness of Klonopin for managing anxiety and panic disorders has not been established.

Seizure Disorders

Klonopin is an effective stand-alone treatment or as an add-on treatment for seizure disorders such as the Lennox-Gastaut syndrome, akinetic, and myoclonic seizures. It is also an effective treatment for petit mal seizures that have not responded to other medications. Klonopin can be used for long-term treatment of seizures, though some people experience a loss of effectiveness with long-term use.[7]

Acute Mania

Off-label Klonopin is more effective than lithium for reducing acute manic symptoms.[8] Klonopin’s use to treat acute manic episodes reduced the duration of the use of antipsychotic drugs to treat acute mania and, in some cases, eliminated the need to use antipsychotic drugs.

Reducing the need for multiple medications or lowering the recommended doses decreases the drug side effects the person has. A combination of benzodiazepine (Klonopin) and antipsychotic (Haloperidol) is the most effective treatment for acute manic agitation.

Other Off-Label Uses

Klonopin, used off-label, is an effective option for treating restless leg syndrome, other movement disorders, insomnia, and REM sleep behavior disorder. However, as these are off-label treatments, they should be short-term, temporary treatment or management plans as there are no studies on the long-term consequences of using Klonopin to treat these disorders.

Risks of Klonopin

Dependence

Long-term use of Klonopin can result in developing a physical dependence on the drug. Physical dependence means that when you try to reduce or stop taking Klonopin, you will experience withdrawal symptoms. You should not stop taking Klonopin abruptly, especially if you have been taking it for a long period. You should work closely with your medical provider to establish a tapering program to reduce your dose slowly.

Acute withdrawal symptoms include[9]

• Abnormal involuntary movements, muscle pain and stiffness
• Anxiety and panic attacks
• Blurred vision
• Depression
• Dizziness
• Fatigue
• Gastrointestinal problems
• Headache
• Hypertension
• Irritability and restlessness
• Insomnia
• Memory impairment
• Tachycardia (a fast heart rate)
• Tremors

Severe acute withdrawal symptoms can be life-threatening and require immediate medical attention. These include[10]

• Catatonia
• Convulsions
• Delirium tremens
• Depression
• Hallucinations
• Mania and psychosis
• Seizures
• Suicidal thoughts

Some people experience protracted withdrawal syndrome after taking Klonopin. This extended period of withdrawal symptoms can last four to six weeks after stopping Klonopin and can continue anywhere from several weeks to a year. Symptoms of protracted withdrawal syndrome include:[11]

• Anxiety
• Cognitive impairment
• Depression
• Insomnia
• Formication (a symptom where you hallucinate the feeling of insects crawling in, on, or under your skin)
• Muscle weakness, tremors, and twitches
• Paresthesia (the feeling of tingling, numbness, or “pins and needles.”)
• Tinnitus

Tolerance

Using Klonopin long-term can result in the development of tolerance. Tolerance is when your body has become accustomed to the drug and no longer responds the same way to the dose you started on. A higher level of Klonopin is now required for you to experience the same effect that a lower dose previously had.

Misuse, Abuse, and Addiction

Klonopin is a benzodiazepine and a central nervous system depressant, which means it has the potential for misuse, abuse, and addiction.

Misuse: is the intentional use of a drug in a manner other than it was prescribed or for whom it was prescribed for therapeutic purposes.

Abuse: is the intentional use of a drug for its desirable psychological or physiological effects that are non-therapeutic.

Addiction: is characterized by behavioral, cognitive, and physiological desires to take the drug, limited abilities to control drug use despite negative consequences, and usually a physical dependence and tolerance.

Even taking Klonopin as prescribed may put a person at risk for abuse and misuse of their prescription drug.[12] Drug abuse and misuse may lead to Klonopin addiction. If you have a history of misusing or abusing medications, you should work closely with your doctor before beginning to take Klonopin. Misuse and abuse of Klonopin often involve taking higher than the recommended dose and co-using other medications, alcohol, and illicit drugs. This increases one’s risk of overdose.

Overdose

Overdose symptoms can appear within a few hours. Klonopin overdoses most frequently happen when they have been taken in combination with other CNS depressants such as alcohol, opioids, and barbiturates. Symptoms of a Klonopin overdose include[13]

• Drowsiness
• Blurred or double vision
• Slurred speech
• Motor impairment
• Respiratory depression
• Low blood oxygen levels
• Low blood pressure
• Slow heart rate
• Heart attack
• Pulmonary aspiration
• Coma
• Death

Cognitive Impairment

Klonopin can impair judgment, thinking, and motor skills. Until one knows how to respond to the medication, one should not attempt tasks requiring mental alertness, such as driving or operating machinery. People who already struggle with cognitive disorders such as Parkinson’s should be monitored for worsening of their condition.

Other Long-Term Effects

Other long-term effects of taking benzodiazepines such as Klonopin include depression, sexual dysfunction, hive-like skin conditions, and paradoxical sleep-related eating disorder (SRED). [14]

Weighing the Risks and Benefits of Long-Term Klonopin Use

After reviewing the risks and benefits above, you should talk with your healthcare provider about using Klonopin. Klonopin can be a beneficial short-term treatment for anxiety disorders and seizure disorders. Research on the effectiveness and consequences of long-term use is limited.

If you and your healthcare provider deem the benefits outweigh the risks of taking Klonopin, you should work closely with your provider to monitor for side effects and tolerance. When it is time to discontinue Klonopin, a tapering schedule should be established to limit the withdrawal side effects.

You should only take Klonopin as prescribed to reduce your risk for misuse and abuse. You should not take Klonopin with other CNS depressant medications or drugs, as this increases your risk for overdose.

Mental health disorders such as anxiety disorders and panic attacks can be managed with behavioral health therapies. These disorders respond well to a combination treatment of psychotherapy and medication. Cognitive behavioral therapy (CBT) and mindfulness practices can reduce your need for long-term use of Klonopin.

Taking Klonopin For Life

Klonopin is an effective short-term medication and, for most people, should not be a life-long medication. There is limited research on the long-term consequences of using Klonopin as it is a short-term use drug. If you have been taking Klonopin for a long period, you should work closely with your healthcare provider to establish a taper schedule, as withdrawal symptoms can be severe if stopped abruptly. Your healthcare provider may explore treatment options with you and encourage you to seek detox treatment to stop taking Klonopin safely and reduce the withdrawal symptoms you may experience.