Klonopin for Social Anxiety Disorder: Side Effects and Interactions

Klonopin (clonazepam) is a medication indicated for the treatment of panic disorder and seizure disorders. It is also used in a variety of other anxiety-related disorders and sometimes prescribed as a second-line treatment for social anxiety disorder (SAD). It's in a class of drugs known as benzodiazepines. Klonopin comes in tablet form and wafer form (orally disintegrating) and is available in strengths of 0.5 mg, 1 mg, and 2 mg.

If your doctor has prescribed Klonopin, you likely have many questions and perhaps even some concerns. It's important that you understand how the medication works as well as how it is intended to be part of your treatment plan.

As with any medication, you also need to know the risks of taking it, as well as how your diet, the other medications you take, and more could affect how it works or lead to health complications.

How is klonopin used
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How Klonopin Treats SAD

Social anxiety disorder, previously called social phobia, is a mental health disorder in which someone experiences intense anxiety around or relating to social situations. This may cause the person to avoid these situations.

Someone with SAD would feel profound worry or panic, possibly result in sweating and a racing heart or physical symptoms, when faced with speaking in front of people, for example. People with SAD have an excessive fear of being judged, viewed negatively, and embarrassed or humiliated.

Benzodiazepines such as Klonopin slow electrical activity in the brain, which is why they are often used to treat anxiety. Klonopin acts quickly on social anxiety symptoms, but the other potential benefits of the medication can take longer to appear.

It's not clear exactly how Klonopin reduces panic, but it's thought to be related to activation of the inhibitory neurotransmitter called gamma-amino butyric acid (GABA). Benzodiazepines calm the brain by binding to GABA receptors.

In the treatment of SAD, benzodiazepines are often taken with an antidepressant such as a selective serotonin reuptake inhibitor (SSRI). These antidepressants are considered the first-line of treatment for SAD. Klonopin may be added if a person with SAD hasn't responded well to an SSRI alone.

Since it acts quickly, Klonopin can be used when needed, such as when performance anxiety hits—say, before someone gives a big presentation or meets a lot of new people. Because anti-anxiety medications such as benzodiazepines run the risk of dependence, a doctor may prescribe them only for the short term.

Contraindications

You should always speak to your doctor about your medical history and work with them to find a treatment that's right for you. People who have certain medical conditions or are in specific circumstances that affect their health might not be able to take Klonopin or need to take precautions.

You should not take Klonopin if you:

  • Have a history of sensitivity to benzodiazepines (such as Ativan, Xanax, or Valium)
  • Have significant liver disease
  • Have been diagnosed with acute narrow-angle glaucoma

Speak with your doctor about Klonopin and any precautions you should know about, particularly if you:

  • Have respiratory disease, or any lung issues
  • Have depression or a history of depression
  • Have suicidal thoughts and behaviors or have had them
  • Are or are planning to become pregnant; are or planning to start breastfeeding
  • Have any kidney or liver issues
  • Have been diagnosed with porphyria
  • Are younger than 18 or older than 64

Klonopin can increase symptoms of depression in some people. If you have a history of depression, you will need to be closely monitored by the doctor who prescribes your medication.

Side Effects

The side effects associated with Klonopin are usually dose-dependent, meaning the more a person takes, the more likely they are to experience side effects. Mild side effects will usually fade away after a few days or weeks.

Common Side Effects

The most common adverse effects people experience when taking Klonopin include:

  • Somnolence
  • Dizziness
  • Trouble with coordination and walking
  • Cognitive impairment
  • Depression

Other side effects of Klonopin include:

  • Blurred vision
  • Changes in sex drive or sexual performance
  • Frequent urination
  • Increased production of saliva
  • Pain in your muscles or joints
  • Unsteadiness
  • Sinus or respiratory problems

After you start Klonopin, your doctor will follow up with you and ask questions about how you have been feeling since you began taking it. This conversation will help them determine the drug's effectiveness in treating your symptoms and gives you a chance to tell them about any side effects you are having. Your doctor can then decide if your dose needs to be adjusted.

Severe

Some potential side effects of Klonopin are serious—even life-threatening. If you take Klonopin with alcohol, illicit drugs, or certain other medications, such as opioid painkillers, it will increase your risk of serious side effects. If someone taking Klonopin exhibits the following symptoms, seek immediate medical care:

  • Extreme sleepiness, loss of consciousness, or unresponsiveness. These can be signs that someone has taken too much Klonopin or mixed it with another medication or substance that is causing a reaction.
  • Trouble breathing, rashes, hives, and swelling of the face, throat, and eyes. These can be signs of an allergic reaction.

While not common, Klonopin can also cause suicidal thoughts and ideations. Contact your doctor immediately if you experience any atypical changes in your behavior or mood, such as:

  • Problems sleeping or insomnia
  • New or worsening anxiety or depression
  • Thinking about dying

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Warnings and Interactions

While you're taking Klonopin, it's important to be aware of its risks. For example, it can be addictive and has potential for misuse, which is why it's classified as a controlled substance.

In 2020, the FDA updated the black box warning on benzodiazepines to call out their potential for addiction, dependence, abuse, and withdrawal.

In addition, if you take other medications besides Klonopin, you should be aware of how these medications could affect one another. Interactions between medications can be mild, moderate, or severe, and they are not limited to prescription medications.

You also need to be aware of any over-the-counter products, herbs, or supplements that are not safe to take with Klonopin. Ask your doctor or pharmacist if you are unsure if it is safe to take your medications or supplements with Klonopin.

Associated Risks

Klonopin poses a serious risk of misuse, abuse, and addiction. This can lead to overdose and even death—particularly when other substances are used at the same time, such as opioids or alcohol.

There is also risk of physical and psychological dependence when you are taking Klonopin. Taking the medication daily for longer than two weeks increases your risk of developing physical dependence.

Stopping Klonopin suddenly can cause withdrawal symptoms, such as seizures, which can be life-threatening. If you want to reduce or stop your dose, talk to your doctor. They can guide you to slowly take less of the medication over time, an approach known as tapering.

Never stop taking Klonopin abruptly without talking to your doctor, even if you are experiencing side effects.

People who are older might be more likely to experience medication side effects, including those that commonly occur with benzodiazepine use. Older people have also had increased risks of falling and negative cognitive effects.

When you start taking Klonopin, avoid activities that could be dangerous to you or others until you have adjusted to the medication. Wait until you know how you feel taking it and how it affects your body before you:

  • Drive
  • Operate heavy machinery
  • Participate in any potentially hazardous activities

Prescription Medications

There are several types, or classes, of prescription drugs that should be used with significant caution when combined with Klonopin. These include:

Several specific prescription medications are known to interact with Klonopin. These medications can change how much Klonopin is in your body as well as how well the drug works. Medications that may increase the levels and effects of Klonopin include:

Medications that may decrease the levels and effects of Klonopin include:

  • Dilantin (phenytoin)
  • Phenobarbital
  • Tegretol (carbamazepine)

Some people with social anxiety disorder also take an antidepressant. You should know that monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs) can enhance the depressant or sedative effects of Klonopin.

The effects of Klonopin may be intensified if they are combined with other drugs or alcohol. Make sure that you tell your doctor about all the medications you take as well as any substances you use—including any over-the-counter products, herbal remedies, and supplements.

OTC Medication and Supplements

Over-the-counter (OTC) medicines or herbal supplements or remedies could interact with Klonopin. Examples include:

  • Antihistamines
  • Cold, cough, and flu symptom relief remedies, especially those that contain certain ingredients, such as dextromethorphan
  • Kava kava
  • Magnesium sulfate (Epsom salts)
  • Proton pump inhibitors (PPIs)
  • St. John's wort
  • Sleep aids, including alternative remedies that contain valerian
  • Tagamet HB (cimetidine)

Also, grapefruit juice may pose a risk. Grapefruit contains compounds that can change how certain medications work. You might not have to give it up completely, but your doctor might advise you to limit how much you have. Check in with them to see if you should avoid it while taking Klonopin.

Proper Disposal

If you have medication that you do not need, make sure you know how to dispose of it properly. Prescription medications cannot necessarily be tossed in your trash or flushed down the drain.

When medications are disposed of improperly, they can harm people, animals, and the environment. For example, drugs that are flushed down the toilet end up in the local water supply, and when medications are thrown out in the garbage, they could find their way to a person who would be harmed by taking them or end up on the street where they would be sold illegally.

To help prevent these outcomes, many hospitals, clinics, pharmacies, and other community organizations offer take-back programs for unused or expired medications.

If your doctor has not given you instructions about what to do with unused Klonopin, ask a pharmacist. They can tell you how to properly dispose of your medication.

A Word From Verywell

If you are prescribed Klonopin for SAD, your doctor has decided that it has the potential to be a positive part of your treatment plan. If you have any questions or concerns about the medication, ask your doctor or pharmacist.

If you don't feel that Klonopin is helping you with your symptoms or you are experiencing intolerable side effects, there are other medications and treatment options you can try.

In addition to medication, your doctor might recommend therapy, such as cognitive behavioral therapy (CBT), during which you work with a therapist to learn how to monitor and alter your thought patterns and behaviors to help you handle situations in a more adaptive way. Cognitive behavioral therapy has been shown to be effective for some people with SAD and other mental health conditions.

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13 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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