Klonopin for Social Anxiety: Dosage, Interactions, and Adverse Effects

Klonopin (clonazepam) is a benzodiazepine that has been shown to be effective in the treatment of panic disorder. It is also sometimes used to treat social anxiety disorder (SAD).

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 Klonopin for social anxiety disorder, as well as how things like your diet and the other medications you take could affect how the Klonopin works or lead to health complications. Here's an overview of what you should know if you have been prescribed Klonopin to treat social anxiety.

How is klonopin used
Verywell / JR Bee

Administration

Klonopin is available as a tablet or an orally disintegrating tablet (wafer). If you have been prescribed regular tablets, you should take them with water. If you have the disintegration tablets, place the wafer on or under your tongue, and allow it to dissolve before swallowing. You don't need to take them with water.

Klonopin is usually taken one to three times a day. You can take your dose with or without food.

Benzodiazepines like Klonopin reduce abnormal electrical activity in the brain, which is why they are often used to treat anxiety. Klonopin's effects on social anxiety symptoms are usually experienced quickly, but the other potential benefits of the medication can take longer to appear.

Dosage Guidelines

The initial daily dosage of Klonopin for panic disorder is 0.5mg to 1mg a day in divided dosages. Your doctor will increase or decrease your dose as needed.

If you are taking Klonopin for social anxiety disorder, your doctor will probably start by prescribing you a low dose of the medication for a limited period of time (such as one week).

They will follow up with you and ask questions about how you have been feeling since you started taking it. This conversation will help them determine the drug's effectiveness in treating your symptoms. It also 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.

Contraindications

People who have certain medical conditions or are in specific circumstances that affect their health might not be able to take Klonopin.

You should not take Klonopin if you:

  • Are pregnant or breastfeeding
  • Are under the age of 18 years
  • Have a history of sensitivity to benzodiazepines (such as Ativan, Xanax, or Valium)
  • Have significant liver or kidney disease
  • Have been diagnosed with acute narrow-angle glaucoma
  • Have been diagnosed with hepatic porphyria

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.

Medication Interactions

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.

This list features some of the most common interactions but is not exhaustive. Ask your doctor or pharmacist if you are unsure if it is safe to take your medications or supplements with Klonopin.

Prescription Medications

There are several types (classes) of prescription drugs that are not considered safe to combine with Klonopin, including:

Several specific prescription medications are known to specifically 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:

  • Luvox (fluvoxamine)
  • Nizoral (ketoconazole)
  • Sporanox (itraconazole)
  • Serzone (nefazodone)
  • Tagamet (cimetidine)

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

  • Dilantin (phenytoin)
  • Luminal (phenobarbital)
  • Tegretol (carbamazepine)

Some people with social anxiety 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

If you regularly take products you get over-the-counter or any herbal supplements or remedies, you should know whether they could interact with Klonopin. Examples of OTC products, herbs, or supplements that can interact with Klonopin include:

  • Antihistamines
  • Cold, cough, and flu symptom relief remedies (especially those that contain certain ingredients, such as dextromethorphan)
  • Grapefruit juice (Although a food rather than a drug, grapefruit is well-known for its potential to change how certain medications work; you might not have to give the fruit up completely, but your doctor might advise you to limit how much you have.)
  • Kava kava
  • Magnesium sulfate (Epsom salts)
  • Proton pump inhibitors (PPIs)
  • St. John's wort
  • Sleep aids (including alternative remedies that contain valerian)

Potential Side Effects

The most common adverse effects people experience when taking Klonopin are somnolence, dizziness, and cognitive impairment. People who are older might be more likely to experience medication side effects, including those that commonly occur with benzodiazepine use.

The side effects associated with Klonopin are usually dose-dependent—the more a person takes, the more likely they are to experience side effects. For example, if a person is initially prescribed 1mg a day and their doctor slowly increases their dose to 3mg or 4mg a day, they might have more side effects or the side effects they felt at 1mg might get more intense.

Some of the commonly reported side effects of Klonopin include:

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

Serious Adverse Effects

Some potential side effects of Klonopin are serious—even life-threatening. If you take Klonopin with alcohol, illicit drugs, or certain other medications (like opioid pain killers), it will increase your risk.

Seek immediate medical care if you have the following symptoms:

  • Extreme sleepiness, loss of consciousness, or unresponsiveness (which 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 your face, throat, and eyes (which can be signs of an allergic reaction)

Associated Risks

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

If you stop taking Klonopin suddenly, it can cause withdrawal symptoms. 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) until you can safely stop.

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

If someone takes too much Klonopin, it is generally not life-threatening except in cases when the medication was combined with other drugs or alcohol.

When you first start taking Klonopin, you need to avoid certain activities that could be dangerous to you or others until you have adjusted to the medication. Until you know how you will feel taking Klonopin and how it will affect your body, do not drive, operate heavy machinery, or participate in any potentially hazardous activities.

Medication 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.

According to the Food and Drug Administration (FDA), certain medications can be safely disposed of in your home trash if you take specific precautions (for example, removing the labels from bottles and crushing up pills).

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 social anxiety disorder, 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 local pharmacist.

If you don't feel that Klonopin is helping you with your social anxiety 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 other types of therapy, such as cognitive behavioral therapy (CBT), during which you work with a therapist to learn how to monitor and alter your thought patterns to help you handle situations in a more adaptive way. CBT has been shown to be effective for some people with social anxiety and other mental health conditions.

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Article Sources
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Additional Reading
  • Kaiser Permanente. Clonazepam. Updated March 2015. ‌