Social Anxiety Disorder Treatment and Therapy Klonopin for Anxiety: What You Need to Know By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on February 15, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Table of Contents View All Table of Contents How Klonopin Treats Anxiety Who Shouldn't Take Klonopin Klonopin Side Effects Warnings and Interactions Proper Disposal Frequently Asked Questions 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 for anxiety, 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. This article discusses how Klonopin treats anxiety and the potential side effects you might experience. It also covers precautions, warnings, and potential drug interactions. Verywell / JR Bee How Klonopin Treats Anxiety Klonapin may be prescribed to treat a number of different anxiety disorders, including social anxiety disorder, panic disorder, and generalized anxiety disorder. 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. People with panic disorder experience severe episodes of anxiety known as panic attacks, while people with generalized anxiety disorder experience a more generalized sense of anxiety that often does not have a specific source. Anxiety leads to symptoms such as profound worry or panic, possibly resulting in sweating and a racing heart or physical symptoms. Other symptoms can include restlessness, irritability, trouble sleeping, muscle tension, and feelings of worry. 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. Signs That You May Have Social Anxiety Disorder Who Shouldn't Take Klonopin 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 diseaseHave 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 issuesHave depression or a history of depressionHave suicidal thoughts and behaviors or have had themAre pregnant or planning to become pregnant; are breastfeeding or planning to startHave any kidney or liver issuesHave been diagnosed with porphyriaAre 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. Klonopin 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: Cognitive impairmentDepressionDizzinessSomnolenceTrouble with coordination and walking Other side effects of Klonopin include: Blurred visionChanges in sex drive or sexual performanceFrequent urinationIncreased production of salivaPain in muscles or jointsUnsteadinessSinus 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. Potential Side Effects of Klonopin Severe Side Effects 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 insomniaNew or worsening anxiety or depressionThinking about dying If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 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: DriveOperate heavy machineryParticipate 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: Antipsychotic agents (thioxanthene and butyrophenone classes) Barbiturates and nonbarbiturate hypnotics Narcotics Other antianxiety drugs Phenothiazines (such as Thorazine) 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: Ketoconazole Luvox (fluvoxamine) Sporanox (itraconazole) Nefazodone Medications that may decrease the levels and effects of Klonopin include: Dilantin (phenytoin)PhenobarbitalTegretol (carbamazepine) Some people with an 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 Medications 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. How to Dispose of Unused or Expired Medications Summary Klonopin is a benzodiazepine that may be prescribed to treat anxiety. It affects electrical and neurotransmitter activity in the brain, which produces a calming effect. Benzodiazepines can be habit-forming and there are side effects that may occur while taking this medication. People with certain medical conditions should not take Klonopin, and the medication may interact with certain medications and supplements. Discussing your medical history with your doctor and always taking Klonopin as prescribed can help reduce these risks. A Word From Verywell If you are prescribed Klonopin for anxiety, 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 anxiety disorders and other mental health conditions. The Best Treatments for Social Anxiety Disorder Frequently Asked Questions How long does Klonopin work for anxiety? Klonopin usually begins working to reduce anxiety around an hour after taking it, although it can take up to four hours to feel the full effects. This medication tends to be longer-acting than some other benzodiazepines. You may continue to feel its anti-anxiety effects for up to 12 hours after taking Klonopin. What does Klonopin do for anxiety? Klonopin may help reduce anxiety in a few different ways. Like other benzodiazepines, it causes slowed electrical activity in the brain, which may improve some anxiety symptoms. It also binds to GABA receptors in the brain, which can have a calming effect. How long can you take Klonopin for anxiety? Because benzodiazepines can be habit-forming, Klonopin is usually not recommended as a long-term treatment. Klonopin is generally used as a short-term treatment for anxiety. While safe when taken as prescribed, physical dependence may occur after two weeks of daily use. Is 1 mg of Klonopin a low dose? The dosage your doctor prescribes will depend on factors such as your age and the condition being treated. Your doctor will typically start you at a low dose, such as 0.25 mg or 0.5 mg two times per day. If this does not relieve symptoms sufficiently, your doctor may increase your dosage. What is a high dose of Klonopin for anxiety? For social anxiety disorder, the maximum dose of Klonopin is typically around 2.5 mg per day. The maximum daily dosage for panic disorder is 4 mg per day. 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. Garakani A, Murrough JW, Freire RC, et al. Pharmacotherapy of anxiety disorders: Current and emerging treatment options. Front Psychiatry. 2020;11. doi:10.3389/fpsyt.2020.595584 Cleveland Clinic. Anxiety disorders. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association. U.S. National Library of Medicine. Clonazepam. U.S. Food and Drug Administration. FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. Roy-Byrne P. Treatment in nonresponsive patients with social anxiety: Back to the future with benzodiazepines. AJP. 2014;171(1):1-4. doi:10.1176/appi.ajp.2013.13101304 Blanco C, Bragdon LB, Schneier FR, Liebowitz MR. The evidence-based pharmacotherapy of social anxiety disorder. Int J Neuropsychopharmacol. 2013;16(1):235-249. doi:10.1017/S1461145712000119 National Institute of Mental Health. Social anxiety disorder: More than just shyness. Sperry L. Klonopin. In. Mental Health and Mental Disorders: An Encyclopedia of Conditions, Treatments, and Well-Being [3 Volumes]. ABC-CLIO; 2015:628-629. doi:9781440803833 National Alliance on Mental Illness (NAMI). Clonazepam (Klonopin). U.S. Food and Drug Administration. Grapefruit juice and some drugs don't mix. U.S. Food and Drug Administration. Safe disposal of medicines. Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: An update on the empirical evidence. Dialogues Clin Neurosci. 2015;17(3):337-346. doi:10.31887/DCNS.2015.17.3/akaczkurkin Additional Reading U.S. Food and Drug Administration. Klonopin tablets. U.S. Food and Drug Administration. Klonopin medication guide. By Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Social Anxiety Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.