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Clonazepam – Depression & Anxiety – When to use it?

Every 4 out of 100 people in the country is suffering from depression. Unemployment, mental torture, deprivation or fetal death of a mother is one of those causes of depression. Health Organization gives a particular view of this depression matter in this article.

In 23rd February Depression and other Common Mental Disorder Global Health Estimate provides the report. In Bangladesh, 6391000 people are suffering from depression which is about 4.1% of the total population.

This estimate includes the South East Asian countries. In Bangladesh and Sri Lanka the rate is similar, but in Bhutan, it is 4% increased. The most number of depressed persons in South Asia lived in India. The percentage of a sad person in India is about 4.5%. The least amount of depressed person lives in East Timor which is only 3% of total population.

Clonazepum

Coping with depression

Coping with depression is not always easy. If any person got depressed his serotonin level become so low that it needs some extra effort to raise his serotonin level. Some regular exercise and play outside or some doing cheerful work can elevate the mood of that depressed person. In our daily life, coping with depression is always take some extra steps. Social meetup, talking with old buddies, sharing the anxiety thoughts with the near ones or watching some good movies still has the positive effects on the mind.


What is the Prevalence of Anxiety and Depression in Bangladesh?

Prevalence of anxiety and depression is increasing in Bangladesh day-by-day. 8.4% of a total population suffering from anxiety disorders and 4.6% with depressive disorders constitute highest among the 11 countries of the World Health Organization Southeast Asia region.

Clonazepam – Depression & Anxiety – When to use it?

It is common for an anxiety disorder to suffer from depression or vice versa. Nearly one half of those diagnosed with depression also diagnosed with an anxiety disorder. Available medicines feet only anxiety or depression but not together. Clonazepam is the only tested and trusted medication that is effective in both anxiety and depression as a single meditation as well as in combination with Other Drugs.

Clonazepam Available Strength in Market

In the market, clonazepam is available in 3 strengths. 0.5, 1, 2 milligrams. The initial dose of anxiety and panic disorder is 0.5-milligram clonazepam once daily. We ask the patient to maintain the therapy of anxiety depression and Insomnia of clonazepam 1 mg tablet. Maintenance dose at the severe stage of disorder and neuropathic pain can be treated by 2-milligram tablet of clonazepam. Clonazepam is proven excellent efficiency in anxiety.

Clonazepam has proven its excellent efficacy in hundreds of clinical trials in different types of anxiety disorders.

Clonazepam offers an excellent treatment option for anxiety disorders. It is proven superior efficacy in both monotherapy and adjuvant therapy in depression.

If we use clonazepam in combination with selective serotonin receptors inhibitor (SSRI), which is anti-depression, it comes better outcome. In the market, there is also an available drug which is called serotonin and not epinephrine reuptake inhibitor in short forms (SNRI), which also shows better patient compliance with clonazepam.

It increases the brain serotonin level, increases serotonin receptor sensitivity, and reduces anxiety and insomnia. Clonazepam accelerates the response and improves the safety in the treatment of depression.

Clonazepam monotherapy in resistant depression

Some patients with significant depressions are resistant to conventional anti-depression therapy. They were given clonazepam 2 milligrams for two weeks.

Result:

A marked improvement appeared within one week of treatment in 84% of patients.

Side Effects wireless and the overall therapy was well tolerated.

Why should we choice clonazepam as first-line therapy of anxiety and panic disorder?

  • Clonazepam has less chance of tolerance development even after long-term use.
  • Clonazepam office an excellent treatment option for anxiety disorders.
  • Clonazepam accelerates the response and increases the safety in the treatment of depression.
  • Clonazepam is high potency benzodiazepine with the Rapid onset of action.


Pharmacology of Clonazepam

Clonazepam has pharmacological properties similar to that of the benzodiazepine class of drugs. Clonazepam has sedative, hypnotic and anticonvulsant properties. Its fundamental anticonvulsant properties are also identical to those of other benzodiazepines.

Indication of Clonazepam

Anxiety as well as panic disorder, with or without agoraphobia. Epilepsy and other seizure disorders. Alone or as an adjunct in the management of myoclonic and akinetic seizures and petit mal variant (Lennox-Gastaut Syndrome). May also be of some value in patients with absence spells (petit mal) who have failed to respond to succinimides.

Dosage & administration of Clonazepam

Dosage must be determined in each patient according to clinical response and tolerance.

Children: the initial dose for infants and children (up to 10 years of age or 30 kg of body weight) should be between 0.01 and 0.03 mg/kg/day and should not exceed 0.05 mg/kg/day given in two or three divided doses. Dosage should be increased by not more than 0.25 to 0.50 mg every third day until a maintenance dose of 0.1 to 0.2 mg/kg of body weight has been reached unless seizures are controlled or side effects preclude further increase.

Whenever possible, the daily dose should be divided into three equal doses. If doses are not equally divided, the larger dose should be given before retiring.

Adults: 1 mg (elderly 500 micrograms) initially at night for 4 nights, increased according to response over 2–4 weeks to a usual maintenance dose of 4–8 mg usually at night (maybe given in 3-4 divided doses if necessary). Dosage may be increased in increments of 0.5 to 1 mg every three days until seizures are adequately controlled. A recommended maintenance dose for adults is 8 to 10 mg/day in three divided doses.

Dosages in excess of 20 mg/day should be administered with caution. The use of multiple anticonvulsants may result in an increase of depressant adverse effects. This should be borne in mind whenever clonazepam is added to an already existing anticonvulsant regimen.

Contraindication of Clonazepam

Significant liver disease, narrow-angle glaucoma, sensitivity to benzodiazepines.

Precautions of Clonazepam

Although simultaneous administration of several anticonvulsants may be considered with clonazepam, such combined therapy may result in an increase of central depressant adverse effects. When used in patients in whom several different types of seizures co-exist, clonazepam may increase the incidence or precipitate the onset of generalized tonic-clonic seizures (grand mal).

Effect of Clonazepam on Pregnancy & lactation

Pregnancy category is ‘C’. The use of clonazepam during pregnancy should be avoided. Mothers receiving clonazepam should not breastfeed their infants.

Side effect of Clonazepam

The most frequently occurring adverse reactions to clonazepam are preferable to CNS depression, drowsiness, ataxia. In some cases, these may diminish with time. Behavior problems and salivation have been noted.

Drug interaction of Clonazepam

Interactions have been reported between some benzodiazepines and other anticonvulsants, with changes in the serum concentration of the benzodiazepine or anticonvulsant.

About Dr. Toufiq Hassan

I am Dr. Toufiq Hassan Shawon, currently working as a medical officer at Trisal Upazilla Health Complex, Mymensingh. I have passed MBBS from Rajshahi Medical College in 2013 January, Batch - 49. My school was B.A.F. Shaheen College, Tejgaon, Dhaka, SSC-2005 and College was Notre Dame College, HSC-2007.

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