While it is rare a person ingests a fatal dose of clonazepam, that doesn't mean that people who are taking this medication shouldn't exercise caution when using it. Clonazepam is a controlled substance that is more likely to be fatal when combined with other medications and substances.
Facts About Clonazepam
Clonazepam is classified as a benzodiazepine. This type of medication is prescribed often and can be used to treat a variety of medical conditions. To fit into this family of medications, a drug must have one or more of the following properties:
Anti-convulsant
Anxiety reliever
Hypnotic
Memory-loss inducer (mild)
Muscle relaxant
Since benzodiazepines are sedatives, they have a high potential for abuse. These medications are listed on Schedule IV of the Controlled Substances Act and have been available on a prescription basis since the late 1950s. The problem of abuse of clonazepam and other benzodiazepines started to be addressed by doctors in the 1980s, which was the same time this class of medications became the most commonly prescribed drugs in North America.
How Clonazepam Works
Clonazepam works by increasing the effects of a brain chemical known as gamma-amino-aminobutyric acid (GABA), which helps create a feeling of calmness. GABA slows down or stops nerve signals in the brain, and this is why it's such an effective medication for treating anxiety disorders.
Fatal Dose of Clonazepam and Mixing Drugs
Unlike barbiturates, clonazepam and other medications in this class are less likely to cause respiratory depression in users. As a result, taking a fatal dose of clonazepam is not as big a concern as it would be for someone who was taking "downers." These medications act as depressants and slow down the user's nervous system. At high doses, the possibility of the user developing shallow respiration or having seizures is a real possibility.
Typical Dosage and Overdose
Depending on the type of physical or mental disorder your doctor is treating, your dose of clonazepam will vary slightly. There are strict guidelines about how much of this benzodiazepine that the patient should not exceed, but keep in mind the severity of the disorder may require slightly more than the recommended guidelines and will be determined by your treating doctor. In general:
For adults taking this medication for seizures, dosage should not exceed around 20 mg per day.
For adults taking this for panic disorder, dosage tends to be around a maximum of 4 mg per day.
With elderly patients, doses typically begin slightly lower than adults due to a susceptibility to confusion, liver problems, drowsiness, and other physical related issues that can impact the effectiveness of the drug.
Minor toxicity has been noted as high as 2,000mg in humans, and the lethal dose in small animals has been recorded at around 13,300mg.
Mixing Drugs With Clonazepam
A person who takes a very high dose of clonazepam is unlikely to die as a result. Of greater concern are the effects the user will experience when clonazepam is mixed with other drugs. People who are using clonazepam may be combining this medication with one or more of the following:
Anticonvulsants
Antidepressants
Antihistamines
Neuroleptics (a type of tranquilizer)
Seizure medications
Sleeping pills
Mixing certain SSRI (Selective Serotonin Reuptake Inhibitors) with clonazepam can increase the medication's sedative effect. High doses of clonazepam may result in the following symptoms:
Difficulty concentrating
Dizziness
Double vision
Drowsiness
Lack of coordination
Mental confusion
Muscle weakness
Slurred speech
Elderly people may be at increased risk for these symptoms since their metabolism may be slower than that of younger adults. Caution should be exercised when operating a motor vehicle after taking clonazepam. The effects of the drug may slow the user's reaction time, which increases the chance of being involved in an accident.
The fact that taking clonazepam in high doses can cause dizziness and lack of coordination puts the user at a higher level of risk for personal injury. The user needs to be careful performing day-to-day activities. He or she could easily slip and fall, causing injury.
Clonazepam and Alcohol
In most cases where a fatal dose of clonazepam has been ingested, the true cause of death was the effect created when this drug is combined with alcohol. Some users combine clonazepam with alcohol and opiates, with fatal results. Alcohol tends to magnify the medication's depressive effects on the user's nervous system, including the functions that control respiration.
Signs of Overdose
These reactions or symptoms are more commonly induced when this drug is mixed with other substances. However if someone who has taken an overdose of clonazepam you may notice:
Slowed reflexes
Changes in breathing
Confusion
Loss of consciousness
Coordination issues
Physical weakness
It is critical to call 911 as soon as possible so the person who overdosed can be treated immediately.
Avoiding Drug Interactions
To lower the risks associated with taking clonazepam and other medications in this class, people who are taking it as a prescribed medication should tell their doctor about all other drugs they are taking, including ones they are using recreationally. The doctor can counsel the patient about drug interactions or prescribe a different dosage that is less likely to cause unwanted side effects if he or she is fully informed. The best dosage for this medication is the lowest one that still provides the desired control of the patient's anxiety symptoms.
