Klonopin for Anxiety: How It Works & Comparisons to Other Medications

How Does Klonopin Help Anxiety?

Klonopin is not FDA-approved for treating anxiety, but it is used off-label for this indication. A drug with a non-FDA-approved use means the drug has not been approved by the FDA for a particular use, but smaller trials have shown safety and clinical benefit. Klonopin may be prescribed as an anxiety treatment taken as 0.25 mg – 2 mg twice daily.

Klonopin for Anxiety

Klonopin can help improve symptoms of anxiety disorders by reducing the frequency and intensity of anxiety, along with enhancing sleep quality.⁶ It can also help ease muscle tension caused by anxiety, panic attacks, and perception of social interactions.^2,3,4,5

Klonopin for Panic Disorder

Klonopin can help improve symptoms of panic disorder by reducing the occurrence of unexpected panic attacks and worries about having attacks.² It can also help reduce worry about the consequences of the attacks and behavioral changes related to the attacks.⁴

Klonopin for Social Anxiety Disorder

Klonopin helps improve symptoms of social anxiety disorder by reducing social fear and avoidance, interpersonal sensitivity, and fears of negative performance evaluation.⁵ Klonopin may also help patients reach remission of social anxiety.⁷

Klonopin Side Effects

Common side effects of Klonopin can cause a person to feel sleepy and dizzy, which can impair thinking and motor function. These effects can make it dangerous to operate machinery or drive a vehicle. While these and other side effects can be mild, sometimes they may be severe enough to require medical attention or to have your treatment adjusted.² Serious side effects, such as difficulty breathing, addiction, coma, and death, are rare but require medical attention.

Common Klonopin side effects include:

• Dizziness
• Drowsiness
• Depression
• Abnormal coordination
• Impaired cognitive and motor function
• Somnolence
• Male sexual issues
• Nervousness

Severe side effects that require immediate medical attention include:

• Extreme sleepiness
• Loss of consciousness
• Difficulty breathing
• Delirium
• Paranoia
• Hallucinations
• Rage, aggression, or hostile behavior
• Mania
• Suicidal ideation and behavior
• Abuse, misuse, or addiction
• Seizures
• Coma
• Death

Common side effects of Klonopin that may be more noticeable when treating anxiety disorders include dizziness, drowsiness, abnormal or impaired cognitive and motor function, somnolence, and male sexual issues. Serious side effects are rare, but if you experience severe side effects from Klonopin, talk to your doctor or pharmacist immediately.

How Long Does Klonopin Take to Work?

Klonopin is a longer-acting benzodiazepine, so it may take longer than other anxiety medications to work, but then will stay in your body for longer. It can start working within a few minutes and may take can take 1-4 hours to see the full effects.² Factors that can affect the timeframe include if you have taken the medicine on a full stomach, as it can take about 3 hours for your stomach to empty and then absorb the medication.²

Klonopin Dosage for Anxiety

Klonopin comes as tablets and orally disintegrating tablets (ODTs). Tablets come as 0.5 mg, 1 mg, and 2 mg, with orally disintegrating tablets also as 0.125 mg.² For panic disorder, the dose is started at 0.25 mg by mouth twice daily. After 3 days, the dose may increase to the target dose of 1 mg per day with a max of 4 mg per day.²

The Klonopin dosage or frequency may be lower if you have kidney, liver, heart, or lung impairment, if you take drugs that can enhance the absorption of Klonopin, or are 65 years or older. Also, your doctor may want to prescribe a lower dose if you are more likely to experience common side effects, such as depression or impaired memory, or coordination.

Here are the available dosages for Klonopin:

• 0.125 mg orally disintegrating tablet
• 0.5 mg tablet and orally disintegrating tablet
• 1 mg tablet and orally disintegrating tablet
• 2 mg tablet and orally disintegrating tablet

Tablets of Klonopin should be taken with water and whole unless otherwise instructed by your doctor. Orally disintegrating tablets should be placed on the tongue and dissolved before swallowing. Both types of tablets can be taken with or without food. Orally disintegrating tablets should be kept in the original packaging, and only the prescribed amount of tablets should be opened at a time. Do not open the packaging until ready to take the tablet.

Can You Overdose on Klonopin?

Though rare, Klonopin overdose can occur even when taking the prescribed amount.² If you take too much or overdose on Klonopin, lay on your side to keep the airway open. If you are with someone who stops breathing, perform mouth-to-mouth resuscitation. If their heart stops beating, begin cardiopulmonary resuscitation (CPR). In the case of an overdose, call 911 immediately. Symptoms of an overdose include drowsiness, confusion, diminished reflexes, and breathing, and coma.²

Klonopin Warnings & Precautions

Serious interactions with Klonopin and alcohol, opioids, and medical conditions can occur, and these medications should not be taken during pregnancy or while breastfeeding. Klonopin should not be suddenly stopped.² Discontinuing abruptly can lead to withdrawal syndrome. Symptoms include impaired concentration, diarrhea, blurred vision, anxiety, and seizures. Withdrawal symptoms and interactions with alcohol and opioids can be dangerous and require immediate medical attention.

Warnings and precautions for taking Klonopin include:

• Interactions with alcohol: Anti-anxiety medications and alcohol can affect your cognitive and motor function. The combination of these two should be avoided.
• Use while pregnant or breastfeeding: When pregnant or breastfeeding, anti-anxiety medications may need to be avoided in some cases. Klonopin can cause neonatal withdrawal syndrome when taken by the pregnant mother.
• Use in children: Children 18 years or younger should not take benzodiazepines for panic disorder, as paradoxical effects, such as aggression, anxiety, nightmares, hallucinations, and psychosis can occur.
• Risk for dependence and withdrawal: Klonopin has a risk of becoming psychologically and physically dependent if abruptly stopped and if your dose is drastically reduced.
• Interactions with opioids: Severe interactions with Klonopin and opioids exist. The combination should be avoided, as breathing may be impaired, leading to coma or death.
• Interference with cognitive and motor performance: Klonopin can impair decision-making and motor skills. Heavy machinery, such as cars and forklifts, should not be operated while taking these medications.
• Worsening depression, suicidal thinking, and behavior: Klonopin may cause suicidal thoughts and behaviors. Appropriate precautions should be taken to prevent overdosing.
• Mania: Mania or hypomania has occurred in patients with depression taking Klonopin.
• Increased salivation: Klonopin can increase salivation, so precautions should be taken for patients with difficulty swallowing or handling secretions.
• Phenylketonurics: Klonopin’s orally-disintegrating form contains phenylalanine and should not be taken if you have trouble metabolizing phenylketonuria.
• Impaired renal, hepatic, or pulmonary function: Since Klonopin can have serious effects, caution should be taken if you have impaired kidney, liver, or lung function.

Klonopin Withdrawal Symptoms

Common symptoms of withdrawal may include depression, drowsiness, and impaired motor function. Severe withdrawal symptoms include delirium, hallucinations, mania, psychosis, seizures, and suicidality.

Severe side effects are rare but can be life-threatening and can occur even if taken as prescribed. Some side effects are common, some are severe, and some are rare. Some side effects may warrant immediate medical attention. Factors that can increase the risk of withdrawal include increased doses.

Drug Interactions With Klonopin

Disclaimer: Taking certain medications, herbs, or supplements alongside benzodiazepines can change how benzodiazepines work in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Klonopin can have harmful interactions if combined with certain substances or medications², so it’s important to speak with your doctor about your lifestyle to make sure that these medications are safe for you. An interaction is when two substances together have a similar adverse effect or cause one’s absorption or elimination to be increased or decreased.

Medications that can negatively interact with Klonopin include:²

• Monoamine oxidase inhibitors (MAOIs): Klonopin and MAOIs can both reduce central nervous system function. Effects can dangerously impact your memory, coordination, and emotions.
• Tricyclic antidepressants (TCAs): Klonopin and TCAs can also interact and impact you central nervous system function.
• Opioids: Opioids and Klonopin can dangerously impair muscle coordination, leading to difficulty breathing, coma, or death.
• Other benzodiazepines: The side effects of benzodiazepines can be enhanced when combined with each other and risk breathing impairment, coma, or death.
• Central Nervous System Depressants: Other medications that can dangerously impact your function when combined with Klonopin include muscle relaxers, trazodone, and sleep aids.
• Anticonvulsants: When combined with Klonopin, anticonvulsants, such as phenytoin, phenobarbital, lamotrigine, and carbamazepine, can also impair cognitive and muscle function.
• Clarithromycin and erythromycin: Antibiotics can decrease Klonopin metabolism, which increases its concentration in the body.
• Fluconazole and ketoconazole: Antifungals can also enhance the amount of Klonopin in the body.
• Proton pump inhibitors and H2 blockers: If taking the orally-disintegrating form, medications that increase your stomach’s pH, such as omeprazole and ranitidine, can lower the absorption of Klonopin.

How to Get a Prescription for Klonopin

Klonopin is an anxiety medication that can be used alone or as an add-on medication. You can get it from your primary care doctor or nurse practitioner. However, they may want you to see a psychiatrist to be sure that Klonopin is right for you based on your medical history and other medications since it can be dangerous. You may also want to consider online psychiatry services.

Alternative Treatments for Anxiety

If you decide you would like to try other anxiety options first, there are alternative medicines and non-medication options. Cognitive behavioral therapy, or CBT for anxiety, is an option that is recognized as one of the best options and is used in combination with medicine. There are many kinds of CBT and different therapists offer different kinds.

Lifestyle changes that can help ease anxiety include a healthy diet, exercise, deep breathing exercises, yoga, and meditation. Certain supplements may help ease anxiety, like matcha and L-theanine.^8,9 Other options include exposure therapy and online group therapy or support groups. Support groups are great when you feel like things are out of your control. Peers can help you come up with solutions and help you realize you are not alone.

Questions to Ask Your Healthcare Provider About Klonopin for Anxiety

You may want to consider taking Klonopin if you have tried several anxiety medications and are still having anxiety symptoms. Ask your doctor, psychiatrist, or therapist if Klonopin is right for you and if there are any side effects you are more likely to have. If you’d like to know more about potential side effects, you can ask your doctor or pharmacist for patient handout information.

Questions to ask your care team when considering the side effects of Klonopin may include:

• Can I use Klonopin along with therapy to treat anxiety?
• How long will it take for me to adjust to taking Klonopin?
• Am I at risk for more severe symptoms if I am already taking other anxiety /depression medications?
• Will a previous history of addiction make me more susceptible to dependency?
• What is the best dosage to ensure fewer side effects?
• Are there drugs I am taking that could have negative interactions?
• When should I reach out to you if I am experiencing side effects?
• Is there anything I should tell my therapist about this new medication?
• Will a previous history of addiction make me more susceptible to dependency?
• How long can I take Klonopin?
• How do I prevent addiction to Klonopin?
• What should I do if I feel like I am becoming addicted to Klonopin?
• Is it safe to take Klonopin with my other medications?
• Will Klonopin be covered by my insurance?
• Does my medical history increase my risk of side effects with Klonopin?
• How long can I expect side effects to last?
• How often should I see you for checkups while taking Klonopin?
• What should I do if I am unsure whether anti-anxiety medications are right for me?

In My Experience

In my experience, patients tend to tolerate Klonopin moderately well and tend to have success. You may have some initial side effects like drowsiness, which should go away after a couple of weeks. Severe side effects are rare and have a greater chance of occurring if you have certain medical conditions or use certain substances. Also, make sure you fully understand your doctor’s instructions when changing doses to prevent side effects.

For Further Reading

• Paxil for Anxiety: Effectiveness, Dosage, & More
• Zoloft For Anxiety: Effectiveness, Dosage, & More
• Effexor (Venlafaxine) For Anxiety: Effectiveness, Dosage, & More
• Klonopin Vs Ativan: Differences, Similarities, & Which to Take
• Benzodiazepines and Job Safety
• Benzodiazepine Withdrawal Support Groups