Clonazepam (Klonipin) is an antianxiety and anticonvulsant prescription medication in the minor tranquilizer, or benzodiazepine, family of drugs. Because it is sedating, long-acting, and is not metabolized through the liver, clonazepam may be used to treat Alcohol Withdrawal Syndrome (AWS).
Alcohol Withdrawal Syndrome
Approximately 8 million people in the U.S. suffer from alcoholic dependency that produces significant withdrawal symptoms when alcohol consumption is stopped. According to information provided by the website Factsandcomparisons.com, within six to 12 hours of the last dose of alcohol, mild withdrawal symptoms such as shaking, increased blood pressure, sweating, and rapid pulse become evident. If not treated, mild symptoms can progress to delirium tremens, or DTs, in the following 48 to 96 hours. DTs can involve nausea, vomiting, hallucinations, intolerance to light and noise, disorientation and convulsions. The severity of symptoms is related to the amount the person is currently drinking per day and how long they have been drinking heavily. Seizures are common and occasionally lethal. Injuries due to falls are also of concern. A quiet environment, plenty of rest, close supervision and judicious use of medications such as clonazepam can improve safety and outcomes of AWS.
Assessment of Withdrawal Symptoms
Clonazepam must be prescribed by a doctor who will base an appropriate dose on several factors such as height and weight of the patient, the likely severity of symptoms and the patient's medical history. For instance, elderly patients with kidney disease will not be able to tolerate high doses, or a patient who is already taking clonazepam for anxiety may need to use different medications for alcohol detox. A fixed schedule of administration may be ordered for home use, but in a hospital or detox center where patients are monitored by trained personnel, doses can be adjusted to symptoms.
A study by St. John's University College of Pharmacology and Allied Health in New York determined that patients who were medicated based on their symptoms had better outcomes and received less medication overall than patients who were under a fixed-dose regimen.
The Clinical Institute Withdrawal Assessment For Alcohol Scale, or CIWA-AR, is a tool used to rate the severity of symptoms. This scale assesses the patient's mental and physical state. Prescribing clonazepam can help with physical symptoms such as tremors, nausea, vomiting and sensory hallucinations. Clonazepam can also help prevent more severe physical symptoms such as seizures.
Clonazepam comes in tablets from .125 mg to 2 mg. According to information from Drugs.com, while .5 mg every eight hours is a starting dose for treatment of seizure disorders, doctors may increase the dose of clonazepam by .5 mg over time until symptoms are controlled. A maximum dose of clonazepam is 20 mg per day in divided doses (5 mg every four hours). Overdose can result in coma, confusion, difficulty of arousal and slowed responses. Dependency on clonazepam can occur. Because of the long half-life of this medication, withdrawal should be done gradually to prevent serious complications.