Clonazepam, trade name, Klonopin, is a member of a class of drugs known as benzodiazepines. Benzodiazepines are appropriate for the short-term treatment of muscle spasms, anxiety and seizures. They are not good choices for the long-term management of these disorders, however, since they create a high degree of tolerance and dependence, and carry significant risks of overdose and abuse. Fortunately, there are other types of medications that are just as effective as Klonopin for long-term therapy and are much safer. These medications sometimes require more time to find the proper dose and produce a therapeutic effect, but once this has been achieved, their efficacy is comparable or superior to that of Klonopin.
Alternatives For Muscle Spasms
Cyclobenzaprine, trade name, Flexeril, is a drug commonly used to treat muscle spasms. It is related to a class of medications know as tricyclic antidepressants, which, in addition to their use for depression, are also sometimes effective against pain. Flexeril has never been shown to have significant antidepressant effects, although it may be of some benefit for pain. This property makes it an attractive option for treating muscle spasms, which are often painful. It carries significantly less overdose risk than Klonopin and does not cause dependence.
Alternatives For Anxiety
Klonopin is a particularly poor choice for the long-term treatment of anxiety, since it has the potential to suppress the REM phase of sleep, and sleep deprivation is known to increase anxiety symptoms. Selective serotonin uptake re-inhibitors, or SSRIs, are medications, such as Lexapro, Paxil and Effexor, which are highly effective against both anxiety and depression. Although they may take several weeks to noticeably decrease anxiety, they are much safer than Klonopin for long-term use. Buspirone, trade name, Buspar, is a medication that is somewhat similar to an SSRI, but it is used only to treat anxiety and not depression. It can be used with an SSRI to help control more severe anxiety. Like SSRIs, Buspar usually takes several weeks to begin reducing anxiety.
Alternatives For Seizures
Phenobarbital and phenytoin, trade name, Dilantin, are older medications that have been used for long-term control of seizures. Although somewhat safer than Klonopin, they share some of the same disadvantages, such as multiple drug interactions, risk of overdose and a sedative effect. Newer anti-seizure medications, which include such drugs as levetiracetam, trade name, Keppra; gabapentin, trade name, Neurontin; and carbamazepine, trade name, Tegretol, are effective with less of these sorts of risks, providing that the proper dose is used. Finding the correct dosage may require multiple adjustments and take several weeks.
References
- "Principles of Pharmacology"; David E. Golan; 2005
- "Current Diagnosis & Treatment: Psychiatry"; Michael H. Ebert; 2008
- "Harrison's Principles of Internal Medicine"; Dennis L. Kasper; 2005
