J Korean Neuropsychiatr Assoc.  2023 Feb;62(1):21-45. 10.4306/jknpa.2023.62.1.21.

Practical Issues With Clonazepam Use

• Kang UG
• Kim SH
• Choi YS
• Lee KY
• Kim YS
• Chung IW

• KMID: 2539670
• DOI: http://doi.org/10.4306/jknpa.2023.62.1.21

Abstract

Clonazepam, a 7-nitrobenzodiazepine, has been used for the treatment of various neuropsychiatric disorders such as seizures, sleep disorders, panic disorders, anxiety, and movement disorders. However, clonazepam is officially approved as a therapeutic drug only for epilepsy and panic disorders in Korea. This raises ethical issues in clinical practice, as clonazepam is prescribed off-label for most neuropsychiatric disorders in many other countries as well. The misuse and abuse of clonazepam as a recreational drug have also been commonly reported in global literature. In this review, as a therapeutic drug as the authors aim to highlight the pharmacological aspects, clinical effects, and potential addictive risks of clonazepam use, by reviewing the current literature on clonazepam to increase its clinical use by accurately understanding and identifying its psychopharmacological benefits and characteristics. However, establishing the risk/benefit ratio of clonazepam for use in specific clinical situations is difficult because of the lack of adequate updated data. Therefore, the use of clonazepam needs to be approached from the point of view of personalized drug treatment rather than following fixed guidelines which would not reflect the current real-world clinical practices.

Keyword

Psychiatric disorders; Benzodiazepine; Clonazepam