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Risk Factors:

Hypersensitivity to clonazePAM. Active narrow-angle glaucoma severe hepatic disease pregnancy.Pregnancy/Lactation: Crosses placenta. May be distributed in breast milk. Chronic ingestion during pregnancy may produce withdrawal symptoms CNS depression in neonates. Children: Long-term use may adversely affect physical/mental development. Elderly: Not recommended in elderly due to anticholinergic effects potential for sedation orthostatic hypotension.

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Indications:

Adjunct in treatment of Lennox-Gastaut syndrome (petit mal variant epilepsy);
akinetic myoclonic seizures; absence seizures (petit mal) unresponsive to
succinimides. Treatment of panic disorder. OFF-LABEL: Burning mouth
syndrome REM sleep behavior disorder essential tremor.

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Adverse Effects:

Frequent (37%?11%): Mild transient drowsiness; ataxia behavioral
disturbances (aggression irriTabletility agitation) esp. in children. Occasional
(10%?5%): Dizziness ataxia URI fatigue. Rare (4% or less): Impaired
memory dysarthria nervousness sinusitis rhinitis constipation allergic
reaction.
Adverse effects/toxic reactions
Abrupt withdrawal may result in pronounced restlessness irriTabletility insomnia
hand tremors abdominal/muscle cramps diaphoresis vomiting status
epilepticus. Overdose results in drowsiness confusion diminished reflexes
coma. Antidote: Flumazenil

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Don’t Use:

Renal/hepatic
impairment impaired gag reflex chronic respiratory disease elderly debilitated
pts depression pts at risk of suicide or drug dependence concomitant use of
other CNS depressants.