NationMaster - Encyclopedia: Clonazepam

Clonazepam (marketed by Roche under the trade-names Klonopin in the United States and Rivotril or Rivatril in Europe, South America, Canada, India, and Australia) is a drug which is a benzodiazepine derivative. It is a highly potent anticonvulsant and anxiolytic.^[1] Clonazepam, also known as 5-(2-chlorphenyl)-1,3-dihydro-7-nitro-2H-1,4- benzodiazepin-2-one, or as 6-(2-chlorophenyl)-9-nitro-2,5 -diazabicyclo [5.4.0]undeca- 5,8,10,12- tetraen-3-one (IUPAC name), is a chlorinated derivative of nitrazepam^[2] and a nitrobenzodiazepine like nitrazepam.^[3] In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body. ... Hoffmann-La Roche, Ltd. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , often abbreviated to benzos) are a class of sedative hypnotic psychoactive drugs with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... An anxiolytic is a drug prescribed for the treatment of symptoms of anxiety. ... Halogenation is a chemical reaction that replaces a hydrogen atom with a halogen atom. ... Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ...

Pharmacology

Clonazepam's primary mechanism of action is via modulating GABA function in the brain, via the benzodiazepine receptor which in turn leads to enhanced GABAergic inhibition of neuronal firing. In addition clonazepam decreases the utilisation of 5-HT (serotonin) by neurons^[4]^[5] and has been shown to bind tightly to central type benzodiazepine receptors.^[6] Because of its strong anxiolytic and anticonvulsant properties, it is said to be among the class of "highly potent" benzodiazepines. The anticonvulsant properties of benzodiazepines are due to inhibition of postsynaptic GABA responses and inhibition of sustained high frequency repetitive firing.^[7] Teva Pharmaceutical Industries Ltd. ... Gaba may refer to: GabÃ¢ or gabaa (Philippines), the concept of negative karma of the Cebuano people GABA, the gamma-amino-butyric acid neurotransmitter GABA receptor, in biology, receptors with GABA as their endogenous ligand Gaba 1 to 1, an English conversational school in Japan Marianne Gaba, a US model... Serotonin (5_hydroxytryptamine, or 5_HT) is a monoamine neurotransmitter synthesised in serotonergic neurons in the central nervous system and enterochromaffin cells in the gastrointestinal tract. ... An anxiolytic is a drug prescribed for the treatment of symptoms of anxiety. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... Benzodiazepine tablets The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ...

Benzodiazepines, including clonazepam, bind to glial cell membranes with high affinity.^[8]^[9] Clonazepam decreases levels of acetylcholine^[10] and decreases prolactin release.^[11] Benzodiazepines inhibit cold-induced thyroid stimulating hormone (also known as TSH or thyrotropin) release.^[12] Benzodiazepines act via micromolar benzodiazepine binding sites as Ca2+ channel blockers and significantly inhibit depolarization-sensitive calcium uptake.^[13] Neuroglia of the brain shown by Golgis method. ... Thyroid-stimulating hormone (also known as TSH or thyrotropin) is a hormone produced by thyrotrope cells in the anterior pituitary gland which regulates the endocrine function of the thyroid gland. ... Thyroid-stimulating hormone (also known as TSH or thyrotropin) is a hormone produced by thyrotrope cells in the anterior pituitary gland which regulates the endocrine function of the thyroid gland. ... Thyroid-stimulating hormone (also known as TSH or thyrotropin) is a hormone produced by thyrotrope cells in the anterior pituitary gland which regulates the endocrine function of the thyroid gland. ...

Mechanism of action

The primary mechanism of action of clonazepam is binding to benzodiazepine receptors, which causes an enhancement of GABA binding. This results in inhibitory effects on the central nervous system.^[14] Benzodiazepines, however, do not have any effect on the levels of GABA in the brain.^[15] While clonazepam has no effect on GABA levels it in addition has no effect on gaba-aminobutyric acid transaminase. Clonazepam does however affect glutamate decarboxylase activity.^[16] Benzodiazepine receptors are found in the central nervous system and have been identified in a wide range of peripheral tissues such as longitudinal smooth muscle-myenteric plexus layer, lung, liver and kidney as well as mast cells, platelets, lymphocytes, heart and numerous neuronal and non-neuronal cell lines.^[17] A diagram showing the CNS: 1. ... A diagram showing the CNS: 1. ... A mast cell (or mastocyte) is a resident cell of connective tissue that contains many granules rich in histamine and heparin. ... A 250 ml bag of newly collected platelets. ... A lymphocyte is a type of white blood cell involved in the human bodys immune system. ...

Benzodiazepine drugs including clonazepam increase the inhibitory processes in the cerebral cortex.^[18]

It has shown itself to be highly effective as a short-term (3 weeks) adjunct to SSRI treatment in obsessive-compulsive disorder and clinical depression in reducing SSRI side effects with the combination being superior to SSRI treatment alone in a study funded by the manufacturers of clonazepam, Hoffman LaRoche Inc.^[19] Similar results have been found with some other anxiety disorders, but the role of the serotonergic effects enhancing the action of the SSRI treatment remains unclear in these cases due to clonazepam's primary anxiolytic mechanism of action. SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... On the Threshold of Eternity. ... ...

Pharmacokinetics

Peak blood concentrations of 6.5–13.5 ng/mL were usually reached within 1–2 hours following a single 2 mg oral dose of micronized clonazepam in healthy adults. In some individuals, however, peak blood concentrations were reached at 4–8 hours.^[20]

Clonazepam passes rapidly into the central nervous system with levels in the brain corresponding with levels of unbound clonazepam in the blood serum.^[21] Clonazepam plasma levels are very unreliable amongst patients. Plasma levels of clonazepam can vary as much as 10 fold between different patients.^[22]

Clonazepam is largely bound to plasma proteins.^[23] Clonazepam is broken down and metabolised to a benzophenone compound.^[24] The metabolites of clonazepam include 7-aminoclonazepam, 7-acetaminoclonazepam, 2-amino-2'-chloro-5-nitrobenzophenone and 2,5-diamino-2'-chlorobenzophenone and 3-hydroxy clonazepam.^[25]^[26] During metabolism of aromatic nitro-containing compounds such as clonazepam produce superoxide free radicals during cellular metabolism by endothelial cells. The nitro anion radical produced during clonazepam metabolism rapidly reacts with oxygen to form the free radical superoxide.^[27]^[28] Benzophenone, also known as diphenylmethanone, phenyl ketone, diphenyl ketone, or benzoylbenzene. ... In chemistry free radicals are uncharged atomic or molecular species with unpaired electrons or an otherwise open shell configuration. ... Lewis electron configuration of superoxide. ...

Tolerance and withdrawal

Like all benzodiazepines, clonazepam is a benzodiazepine receptor agonist. Long-term use (more than 2–4 weeks) can lead to a number of problems, including muscle weakness and fatigue, tolerance, physical dependence and withdrawal syndromes upon discontinuation. The benzodiazepine withdrawal syndrome, which may appear during reduction or withdrawal of clonazepam treatment, can be reduced in intensity with gradual reduction of dosage. Physical dependence refers to a state resulting from habitual use of a drug, where negative physical withdrawal symptoms result from abrupt discontinuation. ... Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ...

In humans tolerance to the anticonvulsant effects of clonazepam occurs frequently.^[29] Chronic use of benzodiazepines leads to the development of tolerance with a decrease of benzodiazepine binding sites. The degree of tolerance is more pronounced with clonazepam than with chlordiazepoxide.^[30] Short term therapy is generally more effective than long term therapy with clonazepam for the treatment of epilepsy.^[31] Many studies have found that tolerance develops to the anticonvulsant properties of clonazepam with chronic use, which limits its long term effectiveness as an anticonvulsant.^[32] Chlordiazepoxide (pronounced [ËˆklÉ”ËrËŒdaÉªÉ™zepËˆoksaÉªd], marketed under the trade name LibriumÂ®) is a sedative/hypnotic drug which is a benzodiazepine derivative. ...

Discontinuation of or reduction in dosage after regular use may result in the clonazepam withdrawal syndrome.^[33] Abrupt or over-rapid withdrawal from clonazepam may result in the development of the benzodiazepine withdrawal syndrome with psychotic attacks characterised by dysphoric manifestations, irritability, aggressiveness, anxiety, and hallucinations.^[34]^[35] Sudden withdrawal from clonazepam may also result in withdrawal symptoms including anxiety, irritability and potentially the life threatening condition status epilepticus. Antiepileptic drugs, benzodiazepines such as clonazepam in particular, should be reduced slowly and gradually when discontinuing the drug to reduce withdrawal effects.^[36] Carbamazepine has been trialed in the treatment of clonazepam withdrawal and has been found to be ineffective in preventing clonazepam withdrawal status epilepticus from occurring.^[37] Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ... Psychosis is a psychiatric classification for a mental state in which the perception of reality is distorted. ... Dysphoria is the opposite of euphoria. ... Carbamazepine (CBZ) is an benzodiazepiene and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. ...

Indications

In the treatment of acute epilepsy via intravenous administration approximately 72.5 per cent of patients show improved EEG patterns, 17.5 per cent show no improvement and for 10 per cent of patients clonazepam has a paradoxical effect and worsens EEG readings.^[40] Anxiety disorder is a blanket term covering several different forms of abnormal, pathological anxiety, fears, phobias. ... Panic Disorder is a psychiatric condition characterized by recurring panic attacks in combination with significant behavioral change or at least a month of ongoing worry about the implications or concern about having other attacks. ... This article is an expansion of a section entitled Mania from within the main article Bipolar disorder. ... This article is about the chemical element. ... Haloperidol (sold under the tradenames Aloperidin, Bioperidolo, Brotopon, Dozic, Duraperidol (Germany), Einalon S, Eukystol, Haldol, Halosten, Keselan, Linton, Peluces, Serenace, Serenase, Sigaperidol) is a conventional, or typical, butyrophenone antipsychotic drug. ... Risperdal tablets Risperidone (pronounced Ris-PER-Ç-dÅn and sold under the trade name Risperdal in the United States, Canada, the United Kingdom, Portugal and several other countries, Risperdal or Ridal in New Zealand, Rispolept in Eastern Europe, and Belivon, or Rispen elsewhere) is an atypical antipsychotic medication developed by... Restless legs syndrome (RLS, Wittmaack-Ekboms syndrome, or sometimes, but inaccurately, referred to as Nocturnal myoclonus) is a condition that is characterized by an irresistible urge to move ones body to stop uncomfortable or odd sensations. ... For other meanings of Paradox, see Paradox (disambiguation). ...

Clonazepam is sometimes used for refractory epilepsies; however, long-term prophylactic treatment of epilepsy has considerable limitations, most notably the loss of antiepileptic effects due to tolerance, which renders the drug useless with long-term use, and also side effects such as sedation, which is why clonazepam and benzodiazepines as a class should generally only be prescribed for the acute management of epilepsies.^[41]

Clonazepam or diazepam has been found to be effective in the acute control of nonconvulsive status epilepticus. However, the benefits tended to be transient in many of the patients and the addition of phenytoin for lasting control was required in these patients.^[42] Phenytoin sodium (marketed as DilantinÂ® in the USA and as EpanutinÂ® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ...

Clonazepam has been found to generally be ineffective in the control of infantile spasms.^[43] Clonazepam is less effective and potent as an anticonvulsant in bringing infantile seizures under control compared with nitrazepam in the treatment of West syndrome, which is an age-dependent epilepsy affecting the very young. However, as with other epilepies treated with benzodiazepines, long-term therapy becomes ineffective with prolonged therapy, and the side effects of hypotonia and drowsiness are troublesome with clonazepam therapy; other antiepileptic agents are therefore recommended for long-term therapy, possibly Corticotropin (ACTH) or vigabatrin. Clonazepam is therefore not recommended for widespread use in the management of seizures related to West syndrome.^[44] Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... West syndrome, otherwise known as infantile spasms, is an uncommon to rare and serious form of epilepsy in infants. ... Hypotonia is a condition of abnormally low muscle tone (the amount of tension or resistance to movement in a muscle), often involving reduced muscle strength. ... Somnolence (or drowsiness, or hypersomnia) is a state of near-sleep, a strong desire for sleep, or sleeping unusually long periods. ... Adrenocorticotropic hormone (ACTH or corticotropin) is a polypeptide hormone secreted from corticotropes in the anterior lobe of the pituitary gland in response to corticotropin-releasing hormone (CRH) released by the hypothalamus. ... Vigabatrin is an anticonvulsant that inhibits the catabolism of GABA. It is an analog of GABA, but it is not a receptor agonist. ...

Clonazepam has been used in the management of seizure disorders in children and also for infantile spasms. However, usefulness of clonazepam is limited due to its dose limiting side effects, especially its negative effect on cognition. West syndrome, otherwise known as infantile spasms, is an uncommon to rare form of malign epilepsy in infants. ...

Availability

Clonazepam was approved in the United States as a generic drug in 1997 and is now manufactured and marketed by several companies. Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... Image File history File links No higher resolution available. ... A generic drug (pl. ...

Clonazepam is available in the U.S. as tablets (0.5, 1.0, and 2 mg) and orally disintegrating tablets (wafers) (0.125, 0.25, 0.5, 1.0, and 2 mg). In other countries, clonazepam is usually available as tablets (0.5 and 2 mg), orally disintegrating tablets (0.25, 0.5, 1 and 2 mg) oral solution (drops, 2.5 mg/mL), as well as solution for injection or intravenous infusion, containing 1 mg clonazepam per ampoule (e.g. Rivotril inj.).

Side effects

Benzodiazepines such as clonazepam can be very effective in controlling status epilepticus but when used for longer periods of time serious side effects may develop such as interference with cognitive functions and behaviour.^[62] Many individuals treated on a long-term basis develop a form of dependence known as "low-dose dependence", as was shown in one double-blind, placebo-controlled study of 34 therapeutic low-dose benzodiazepine users—physiological dependence was demonstrated via flumazenil-precipitated withdrawal.^[63] Use of alcohol or other CNS depressants while taking clonazepam greatly intensifies the effects (and side effects) of the drug. Side effects of the drug itself are generally benign, but sudden withdrawal after long-term use can cause severe, even fatal, symptoms. Anterograde amnesia is a form of amnesia, or memory loss, in which new events are not transferred from short-term memory to long-term memory. ... For other uses, see Hangover (disambiguation). ... Look up dysphoria in Wiktionary, the free dictionary. ... Thrombocytopenia (or -paenia, or thrombopenia in short) is the presence of relatively few platelets in blood. ... Psychology (ancient Greek: psyche = soul and logos = word) is the study of mind, thought, and behaviour. ... Psychiatry is a branch of medicine that studies and treats mental and emotional disorders (see mental illness). ... For other uses, see Psychosis (disambiguation). ... Look up incontinence in Wiktionary, the free dictionary. ... For the beer, see Delirium Tremens (beer). ... Cognitive The scientific study of how people obtain, retrieve, store and manipulate information. ... Pharmacotherapy is the practice of treating diseases with medication. ... Physiology (in Greek physis = nature and logos = word) is the study of the mechanical, physical, and biochemical functions of living organisms. ... Flumazenil (flumazepil, AnexateÂ®, LanexatÂ®, MaziconÂ®, RomaziconÂ®) is a benzodiazepine antagonist, used as an antidote in the treatment of benzodiazepine overdose. ... A diagram showing the CNS: 1. ...

Special precautions

Caution in the Elderly. Increased risk of impairments, falls and drug accumulation.^{[citation needed]}

Caution in children. Clonazepam is not recommended for use in those under 18. Use in very young children may be especially hazardous. Of anticonvulsant drugs behavioural disturbances occur most frequently with clonazepam and phenobarbital.^[64] Phenobarbital (INN) or phenobarbitone (former BAN) is a barbiturate, first marketed as Luminal by Friedr. ...

Caution using high dosages of clonazepam. Doses higher than 0.5 - 1 mg per day is associated with significant sedation.^[65]

Clonazepam may aggravate hepatic porphyria.^[66]^[67] Hepatic porphyrias can refer to: hereditary coproporphyria acute intermittent porphyria porphyria cutanea tarda hepatoerythropoietic porphyria variegate porphyria erythropoietic protoporphyria Porphyrias Erythropoietic porphyria MeSH Porphyrias,+Hepatic Categories: | ...

Caution in schizophrenia. Clonazepam has been found to be not effective in the management of schizophrenia and has been found to increase the risk of violent behavior.^[68]

Interactions

Clonazepam decreases the levels of carbamazepine,^[69]^[70] and likewise be reduced in its levels by carbamazepine.^[71] Clonazepam may affect levels of phenytoin (diphenylhydantoin) by decreasing,^[69]^[72] or increasing.^[73]^[74] In turn Phenytoin may lower clonazepam plasma levels, by increasing the speed of clonazepam clearance by approximately 50% and decreasing its half life by 31 per cent.^[75] Clonazepam increases the levels of primidone,^[73] and phenobarbital.^[76] Carbamazepine (CBZ) is an benzodiazepiene and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. ... Phenytoin sodium (marketed as DilantinÂ® in the USA and as EpanutinÂ® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ... Primidone is an anticonvulsant of the pyrimidinedione[4] class whose active metabolites, phenobarbital (major) and phenylethylmalonamide (PEMA) (minor), are also anticonvulsants. ... Phenobarbital (INN) or phenobarbitone (former BAN) is a barbiturate, first marketed as Luminal by Friedr. ...

Warnings

Clonazepam, like many other benzodiazepines, may impair one's ability to drive or operate heavy machinery. The central nervous system depressing effects of the drug can be augmented by alcohol consumption. Benzodiazepines have been shown to cause both psychological and physical dependence. Patients physically dependent on clonazepam should be slowly titrated off under the supervision of a qualified healthcare professional to reduce the intensity of withdrawal or rebound symptoms.

Protracted withdrawal

Protracted benzodiazepine withdrawal syndrome, occurs in some individuals after discontinuation of benzodiazepine drugs. Symptoms can persist for months or years. In some cases protracted withdrawal may be due to physicochemical neuronal damage which may be permanent or only slowly reversible.^[77] Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ... Neurons (also called nerve cells) are the primary cells of the nervous system. ...

However not all experts agree. In 1993 the New England Journal of Medicine published a paper claiming that there is no reliable evidence to support the existence of a persistent benzodiazepine withdrawal syndrome, and this alleged syndrome has been described only in anecdotal reports, with patients typically reporting "withdrawal" symptoms not present during or before benzodiazepine treatment that persist for many months or years after treatment is stopped. Experimental neuropharmacologic studies document that all the side effects of benzodiazepines, whether behavioral or neurochemical, disappear within several days or weeks after the drug is eliminated. The weight of evidence indicates that any new symptoms that persist for more than two months after the last dose of a benzodiazepine either are part of the premorbid condition or have appeared by coincidence or as a consequence of the natural history of the underlying illness.^[78]

In a more recent medical paper published in 1995 it was claimed that about 10 - 15% of people who withdraw from benzodiazepines develop a protracted withdrawal syndrome. The protracted withdrawal syndrome is due to pharmacological withdrawal symptoms involving the slow reversal of receptor changes which have developed over time due to pharmacological drug tolerance. The protracted withdrawal syndrome persists for many months or years and occasionally some symptoms may be permanent. There is some evidence that chronic use of benzodiazepines cause dose related structural brain damage.^[79]

Hoffmann–La Roche pharmaceutical company, the manufacturer of clonazepam, in a 2007 product information publication, acknowledges the existence of protracted benzodiazepine withdrawal syndromes and recommends that its product flumazenil is not used to treat protracted benzodiazepine withdrawal syndromes.^[80] F. Hoffmannâ€“La Roche, Ltd. ... Flumazenil (flumazepil, AnexateÂ®, LanexatÂ®, MaziconÂ®, RomaziconÂ®) is a benzodiazepine antagonist, used as an antidote in the treatment of benzodiazepine overdose. ...

The below list of some protracted withdrawal symptoms comes from a 2004 publication by Professor Ashton.^[81]

Pregnancy

There is some medical evidence of various malformations e.g. cardiac or facial deformations when used in early pregnancy, however the data is not conclusive. The data is also inconclusive whether benzodiazepines such as clonazepam cause developmental deficits or decreases in IQ when taken during pregnancy. Clonazepam when used late in pregnancy may result in the development of a severe benzodiazepine withdrawal syndrome in the neonate and also floppy infant syndrome. Withdrawal symptoms from benzodiazepines in the neonate may include hypotonia, and reluctance to suck, to apnoeic spells, cyanosis, and impaired metabolic responses to cold stress. These symptoms may persist for hours or months after birth.^[82] A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ... A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ... Hypotonia is a condition of abnormally low muscle tone (the amount of tension or resistance to movement in a muscle), often involving reduced muscle strength. ... Apnea (British spelling - apnoea) is the absence of external breathing. ... Cyanosis refers to the bluish coloration of the skin due to the presence of deoxygenated hemoglobin in blood vessels near the skin surface. ... Santorio Santorio (1561-1636) in his steelyard balance, from Ars de statica medecina, first published 1614 Metabolism (from μεταβολισμος(metavallo), the Greek word for change), in the most general sense, is the ingestion and breakdown of complex compounds, coupled with the liberation of energy, and the consequent generation of waste...

Overdose

An individual who has consumed too much clonazepam will display one or more of the following symptoms:

Coma can be cyclic with the individual alternating from a comatose state to a hyperalert state of consciousness, as occurred in a 4-year-old boy who suffered an overdose of clonazepam.^[83] The combination of clonazepam and certain barbiturates eg amobarbital at prescribed doses has resulted in a synergistic potentiation of the effects of each drug leading to serious respiratory depression.^[84] For other uses, see Coma (disambiguation). ... In physiology and medicine, hypotension refers to an abnormally low blood pressure. ... Somnolence (or drowsiness) is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. ... For other uses, see Nausea (disambiguation). ... Amobarbital (formerly known as amylobarbitone) is a drug that is a barbiturate derivative. ... This page is a candidate to be copied to Wiktionary. ...

Recreational use and abuse

Clonazepam is one of the most commonly abused prescription drugs.^[85] A nation wide USA government study conducted by SAMHSA found that benzodiazepines in the USA are the most frequently abused pharmaceutical drug with 35% of drug related visits to the Emergency Department involving benzodiazepines. Benzodiazepines are more commonly abused than opiate pharmaceuticals which accounted for 32% of visits to the emergency department. No other pharmaceutical is more commonly abused than benzodiazepines. Males abuse benzodiazepines as commonly as females. Of drugs used in attempted suicide, benzodiazepines are the most commonly used pharmaceutical drug with 26% of attempted suicides involving benzodiazepines. The most commonly abused benzodiazepine is alprazolam. Clonazepam is the 2nd most abused benzodiazepine in the USA. Lorazepam is the 3rd most commonly abused benzodiazepine and diazepam the 4th most commonly abused benzodiazepine in the USA.^[86] Substance Abuse and Mental Health Services Administration (SAMHSA) is the US Federal agency charged with improving the quality and availability of prevention, treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses. ... Benzodiazepine tablets The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ... Alprazolam, also known under the trade names Xanax and Niravam, is a short-acting drug in the benzodiazepine class used to treat severe anxiety disorders and as an adjunctive treatment for anxiety associated with clinical depression. ... Lorazepam is a benzodiazepine tranquilizer with short to medium duration of action. ... Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche) is a benzodiazepine derivative drug. ... Motto: (traditional) In God We Trust (official, 1956â€“present) Anthem: The Star-Spangled Banner Capital Washington, D.C. Largest city New York City Official language(s) None at the federal level; English de facto Government Federal Republic - President George W. Bush (R) - Vice President Dick Cheney (R) Independence - Declared - Recognized...

Rivotril is frequently used among inmates in East European prisons.^{[citation needed]}

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A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Medscape is a free site containing peer-reviewed information written at the level of physicians and other health profesionals, but open to anyone who registers. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 364th day of the year (365th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 268th day of the year (269th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Substance Abuse and Mental Health Services Administration (SAMHSA) is the US Federal agency charged with improving the quality and availability of prevention, treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses. ...

GABA analogs: Gabapentin, Pregabalin, Progabide, Vigabatrin -- Monosaccharides: Topiramate -- Aromatic allylic alcohols: Stiripentol -- Ureas: Phenacemide, Pheneturide -- Phenyltriazines: Lamotrigine

Carbamates: Emylcamate, Felbamate, Meprobamate -- Pyrrolidines: Brivaracetam, Levetiracetam, Nefiracetam, Seletracetam Brotizolam (marketed under brand name Lendormin) is a drug which is thienobenzodiazepine (a benzodiazepine derivative). ... Clotiazepam (marketed under brand name Trecalmo) is a drug which is a benzodiazepine derivative. ... Etizolam (marketed under brand name Sedekopan) is a drug which is a benzodiazepine derivative. ... Arfendazam is a drug which is a benzodiazepine derivative. ... Clobazam is triazolobenzodiazepine, also known as a 1,5-benzodiazepine, meaning that its diazepine ring has its nitrogen atoms at the 1 and 5 positions instead of the usual 1 and 4. ... Lofendazam is a drug which is a benzodiazepine derivative. ... Triflubazam is a drug which is a 1,5-benzodiazepine derivative, related to clobazam. ... Girisopam (GYKI-51189) is a drug which is a 2,3-benzodiazepine derivative, related to tofisopam. ... GYKI-52895 is a drug which is a 2,3-benzodiazepine derivative. ... Nerisopam (GYKI-52322) is a drug which is a 2,3-benzodiazepine derivative, related to tofisopam. ... Tofisopam (marketed under brand name Emandaxin) is a drug which is a benzodiazepine derivative. ... Avizafone is the international non-proprietary name (INN) for a water soluble prodrug of diazepam. ... Rilmazafone (Rhythmy, 450191-S) is a water-soluble benzodiazepine prodrug developed in Japan. ... Bentazepam (also known as Thiadipone) is a drug which is a benzodiazepine derivative. ... Ketazolam (marketed under brand names Anseren, Anxon, Contamex, Loftran, Marcen, Sedotime, Solatran, Unakalm) is a drug which is a benzodiazepine derivative. ... Tifluadom is a benzodiazepine derivative with an unusual activity profile. ... Zolazepam is a benzodiazepine derivative used as an anaesthetic for a wide range of animals in veterinary medicine. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... A section of the Anatomical Therapeutic Chemical Classification System. ... Barbituric acid, the basic structure of all barbiturates Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Barbexaclone (marketed in Italy as Maliasin by Abbott Laboratories). ... Metharbital was marketed as Gemonil by Abbott Laboratories. ... Methylphenobarbital (also known as mephobarbital) is marketed in the US as Mebaral by Ovation. ... Pentobarbital is a short acting barbiturate that is available as both a free acid and a sodium salt, the former of which is only slightly soluble in water and ethanol. ... Phenobarbital (INN) or phenobarbitone (former BAN) is a barbiturate, first marketed as Luminal by Friedr. ... Primidone is an anticonvulsant of the pyrimidinedione[4] class whose active metabolites, phenobarbital (major) and phenylethylmalonamide (PEMA) (minor), are also anticonvulsants. ... Hydantoin, which is also known as glycolylurea, is a heterocyclic organic compound which can be thought of as a cyclic double-condensation reaction product of glycolic acid and urea. ... Ethotoin (marketed as PeganoneÂ® by Ovation) is an anticonvulsant drug used in the treatment of epilepsy. ... Fosphenytoin (CerebyxÂ®, Parke-Davis) is a water-soluble phenytoin prodrug used in only in hospitals for the treatment of epileptic seizures. ... Mephenytoin (marketed as MesantoinÂ® by Novartis) is a hydantoin, used as an anticonvulsant. ... Phenytoin sodium (marketed as DilantinÂ® in the USA and as EpanutinÂ® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ... The following are oxazolidinediones: paramethadione trimethadione ethadione Categories: Pharmacology stubs | Antiepileptics ... Ethadione is an anticonvulsant medication in the oxazolidinedione family. ... Paramethadione is an anticonvulsant in the oxazolidinedione class. ... Trimethadione is an oxazolidinedione anticonvulsant. ... Succinimides are drugs that can be used as anticonvulsants. ... Ethosuximide is a succinimide anticonvulsant, used mainly in absence seizures. ... Mesuximide (or methsuximide) is an anticonvulsant medication. ... Phensuximide is an anticonvulsant in the succinimide class. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , often abbreviated to benzos) are a class of sedative hypnotic psychoactive drugs with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ... Clobazam is triazolobenzodiazepine, also known as a 1,5-benzodiazepine, meaning that its diazepine ring has its nitrogen atoms at the 1 and 5 positions instead of the usual 1 and 4. ... Clorazepate (marketed under the brand names TranxeneÂ® and TranxiliumÂ®) is a drug which is a benzodiazepine derivative. ... Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche) is a benzodiazepine derivative drug. ... Lorazepam is a benzodiazepine tranquilizer with short to medium duration of action. ... Midazolam (marketed under brand names VersedÂ®, HypnovelÂ®, DormicumÂ® and DormonidÂ®, pronounced ) is a drug which is a benzodiazepine derivative. ... Nimetazepam (marketed under brand name EriminÂ®) is a drug which is a benzodiazepine derivative. ... Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... Temazepam (marketed under brand names RestorilÂ®, NormisonÂ®, PlanumÂ®, TenoxÂ® and TemazeÂ®) is a benzodiazepine derivative with powerful hypnotic properties. ... Carboxamides are drugs that can be used as anticonvulsants. ... Carbamazepine (CBZ) is an benzodiazepiene and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. ... Oxcarbazepine (marketed as TrileptalÂ® by Novartis or Trexapin by Taro) is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. ... Rufinamide is an anticonvulsant medication. ... Not to be confused with fats. ... Valpromide (dipropylacetamide, Î±-propylvaleramide, Diprozin) is a carboxamide derivative of valproic acid that is considered safer to use than either valproic acid or sodium valproate. ... Valnoctamide has been used in France as a tranquilizer and muscle relaxant since 1964[3] and as an anticonvulsant since starting in 1969 in Portugal. ... Structure of a carboxylic acid The 3D structure of the carboxyl group A space-filling model of the carboxyl group Carboxylic acids are organic acids characterized by the presence of a carboxyl group, which has the formula -C(=O)OH, usually written -COOH or -CO2H. [1] Carboxylic acids are Bronsted... Valproic acid (VPA) is a chemical compound that has found clinical use as an anticonvulsant and mood-stabilizing drug, primarily in the treatment of epilepsy and bipolar disorder. ... Sodium valproate (INN) or valproate sodium (USAN) is the sodium salt of valproic acid and is an anticonvulsant used in the treatment of epilepsy. ... Valproate semisodium (INN) or divalproex sodium (USAN) consists of a compound of sodium valproate and valproic acid in a 1:1 molar relationship in an enteric coated form. ... Tiagabine is an anti-convulsive medication produced by Cephalon and marketed under the brand name Gabitril. ... Gaba may refer to: GabÃ¢ or gabaa (Philippines), the concept of negative karma of the Cebuano people GABA, the gamma-amino-butyric acid neurotransmitter GABA receptor, in biology, receptors with GABA as their endogenous ligand Gaba 1 to 1, an English conversational school in Japan Marianne Gaba, a US model... Gabapentin (brand name Neurontin) is a medication originally developed for the treatment of epilepsy. ... Pregabalin (brand name: LyricaÂ®) is a new anticonvulsant drug indicated as an add on therapy for partial onset seizures and for certain types of neuropathic pain. ... Progabide (INN) is an analog of gamma-aminobutyric acid used in the treatment of epilepsy. ... Vigabatrin is an anticonvulsant that inhibits the catabolism of GABA. It is an analog of GABA, but it is not a receptor agonist. ... Monosaccharides are the simplest form of carbohydrates. ... Topiramate (brand name Topamax) is an anticonvulsant drug produced by Ortho-McNeil Neurologics, a division of Johnson & Johnson. ... In chemistry, an aromatic molecule is one in which electrons are free to cycle around circular arrangements of atoms, which are alternately singly and doubly bonded to one another. ... An allyl group is an alkene hydrocarbon group with the formula H2C=CH-CH2-. It is made up of a vinyl group, CH2=CH-, attached to a methylene -CH2. ... This article does not cite any references or sources. ... Stiripentol (marketed as Diacomit by Laboratoires BIOCODEX) is an anticonvulsant drug used in the treatment of epilepsy. ... Urea is an organic compound with the chemical formula (NH2)2CO. Urea is also known by the International Nonproprietary Name (rINN) carbamide, as established by the World Health Organization. ... Phenacemide is an anticonvulsant of the urea class. ... Pheneturide (or ethylphenacemide) is an anticonvulsant medication. ... Lamotrigine (marketed as Lamictal (IPA: ) by GlaxoSmithKline, called Lamictin in South Africa, (Lamogine)[1] in Israel, and in South Korea) is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. ... Carbamates are a group of organic compounds sharing a common functional group with the general structure -NH(CO)O-. More precisely the carbamate group is considered an amide group with an alkoxy or hydroxy functional group next to the carbonyl group. ... Emylcamate (marketed as StriatranÂ® by Merck) is an anxiolytic and muscle relaxant. ... Felbamate (marketed as Felbamol by MedPointe) is an anticonvulsant drug used in the treatment of epilepsy. ... Meprobamate (marketed under the brand names Miltown by Wallace Laboratories, Equanil by Wyeth, and Meprospan) is a carbamate derivative which is used as an anxiolytic drug. ... Flash point 3 Â°C R/S statement R: 11 20/21/22 35 S: 16 26 28 36/37 45 RTECS number UX9650000 Related compounds Related compounds pyrrole piperidine Except where noted otherwise, data are given for materials in their standard state (at 25 Â°C, 100 kPa) Infobox disclaimer and... Brivaracetam is a racetam derivative with anticonvulsant properties. ... Levetiracetam (INN) (pronounced ) is an anticonvulsant medication used to treat epilepsy. ... Categories: Stub | Substances of the piracetam group ... Seletracetam is a nootropic drug of the racetam family. ...

Sulfa drugs: Acetazolamide, Ethoxzolamide, Sultiame, Zonisamide -- Propionates: Beclamide -- Aldehydes: Paraldehyde -- Bromides: Potassium bromide, Sodium bromide

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