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What does clonazepam do to the brain ? Does it cause real brain damage ?


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Some speculation, some theories, some questions.


First of all, I've spent a lot of time reading about the peculiarities of clonazepam (Rivotril, Klonopin).


Just not recently.


It's just depressing.


So many articles, opinions. I don't want to revisit all of them !


As far as brain damage is concerned, a distinction between structural brain damage and functional brain damage is usually made. The former referring to brain damage in the classical sense, physical damage to brain cells (apoptosis, damaged connections, shrinkage of white matter/grey matter), the latter referring to the brain not working as it is supposed to.


Recently I read something like this: 'it is known what clonazepam does in the brain of epileptics, but not what it does in the brain of people who do not have epilepsy'. Remember, clonazepam was originally marketed for epilepsy.


I've read stories/articles (?) stating that clonazepam causes brain damage similar to what long term alcoholics experience. Or perhaps that was about regular use of clonazepam with regular but limited intake of alcohol ?


Please don't try to cheer me up. I'd just like to know what this poison does.


Supposedly (Ashton) all benzo are about the same. Aside from the fact that prof Ashton's work at the time did not include the newer benzodiazepines (alprazolam, lorazepam, clonazepam) she states:




'It is well known that Klonopin is a good anticonvulsant. In fact its only indication for use in the UK is for epilepsy. The fact that it has a higher affinity for GABA-A receptor sites than diazepam simply means that it is more potent, but potency is mainly a matter of equivalent dosages. Binding of clonazepam to receptors that do not bind to other benzodiazepines and action on sodium channel conductors are relevant to anticonvulsant effects, not tranquillising effects. The fact that clonazepam has sedative and anxiolytic actions and typical adverse effects of benzodiazepines including ataxia, irritability, depression and tolerance shows that there is little overall difference'


I would not know why only tranquilising effects would be relevant. After long term use the body reacts to everything the drug does.


What are benzodiazepines ?

Quoting wikipedia (with a minor modification) as a matter of convencience: 'a drug whose core chemical structure is the fusion of a benzene ring and a diazepine ring' So a benzo is defined by the basic chemical 'core', not what it does.

Some benzos have therapeutic value, some don't. Some have anticonvulsant properties, some have convulsant properties.


What is the benzodiazepine receptor ? Was it an empty slot waiting for the discovery of Valium ?

Recently, the 'benzodiazepine receptor' was renamed to the 'benzodiazepine site' on the GABA-A receptor.

All sorts of chemicals naturally occuring in the body bind to the benzodiazepine site. Some are proconvulsant !

Basically, the pharmaceutical benzos hijack the human physiology and to some extent displace naturally occuring substances.

If one takes a long-acting benzo all the time, that will have consequences. Most of the time.


Back to clonazepam. I've been able to find very little reliable information.

Supposedly, it affects the glutamate decarboxylase enzyme. Meaning, there will be more GABA in the brain !

I would not be suprised if benzos affect different parts of the brain somewhat selectively. Depending on the benzo.

Supposedly, clonazepam acts on serotonin. Lots of references can be found. All sorts of references about clonazepam affecting GABAB postsynaptically, presynaptically in different parts of the brain. Complicated.


When I'm in a somewhat gloomy mood I'm inclined to think that clonazepam causes long-term structural changes in the brain. Which is NOT good. But quite possibly true. It often feels like it.


I'm not looking for someone to cheer me up. But feel free to respond. I've had plenty of bizarre reactions while in withdrawal. Nothing like I had from short-term or infrequent use of hypnotics.

Especially while in withdrawal, subjective time moving very slow. After taking the clonazepam, 'time' speeds up again.

And more.


Technically clonazepam is a CNS depressant. For me, clonazepam has both sedative and stimulating properties.

It's a very weird drug. On a few occasions when I took less than 1 mg it caused more than minor neuropathic pain.


Does clonazepam cause long term structural changes in the human brain ? More so than just upregulation and downregulation of receptors ?

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There is no doubt in my mind that clonazepam is a powerful drug that alters brain chemistry. It changed me into a different person when I was on it and it ruined my life for months after I stopped taking it.




I will be 9 month off Saturday, and although I am not 100% recovered, I am substantially recovered, and I continue to get better and better every week. Not only that, but when I have had windows I feel 100% normal. Actually BETTER than normal. So I know the capacity for me getting through this is there.


Does clonazepam cause brain damage? I'm no doctor of scientist but based upon my firsthand experience with taking the drug and subsequently withdrawing from it, I would have to say yes it does. If a substance can have a profound effect on your cognitive abilities (among many other things) a year after you stop taking it how could you argue that it hasn't caused "damage" to your brain? Fortunately my experience (and most everything I have read on the subject) has also shown me that the brain is able to recover from whatever damage the drug causes, usually with a year or two.


It's not fair, I know, but life in general isn't fair. When you peel back the thin veneer of niceties the world is an ugly place. The kind of place where the people who are supposed to heal you can make you sick, even ruin your life out of ignorance and greed. Just gotta move forward and get past this and apply the lesson to make our lives better.





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I have seen this concern come up time and time again.  The only way you are going to get a true answer is if you go and get a CT scan and or MRI by a Neurologist.  If your interest is that strong and you have to know.  This would answer the structural part of the equation.  As for the functional, I have to agree with Florida Guy, I have seen and read too much to believe that it wouldn't be reversible. 


You are not alone in your quest to know the truth.  I plan on getting similar tests done.  I have had 3 CT scans this month for something unrelated so I have to wait a long while before I can.  Whatever the outcome may be, I will not allow myself to get discouraged.  The body is a self healing entity and the brain is no different. 



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To be honest, I'm reluctant to see what those scans would show. What if it shows that my brain is severely damaged ?


Anyway, seeing a neurologist isn't practical. I'm not in the USA, we don't have a commercial healthcare system and I can't just visit a neurologist. 'benzo withdrawal' is handled by a GP or by psychiatry :(

I'd probably have to travel. Most likely not worth the money.


For scans, you'd need highly sophisticated equipment or it probably wouldn't work anyway.

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I wouldn't worry about things like that for two reasons.  The first is that if there was structural brain damage, I believe there would be symptoms beyond those of benzo w/d.  Remember the brain controls every aspect of the body.  Second, I don't really see the point in worrying about things I can't control.  I know you fear this stuff.  All of us do once we read all there is to know about them.  Truth is, there weren't  enough studies done to prove that benzos could do damage to the brain.  The information that we do have comes from a Malcom Lader study done 30 years ago that didn't have very many patients.  What I see more and more of  in these threads is that people go and get themselves checked out only to find nothing wrong.  I say we allow ourselves to heal first. 



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It's not fair, I know, but life in general isn't fair. When you peel back the thin veneer of niceties the world is an ugly place. The kind of place where the people who are supposed to heal you can make you sick, even ruin your life out of ignorance and greed.







Anyway, If you ask me benzos cause a unique form of brain damage. I mean without getting into medical definitions of brain damage, heres the definition of damage; "Physical harm caused to something in such a way as to impair its value, usefulness, or normal function."


I would say it has damaged my brain, I also think the damage is completely reversible in most people, especially young healthy people.



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Well, I'm not young (early fourties) so that doesn't help.


I've had some extreme and bizarre symptoms.

Movement disorders, balance problems. At one point it seemed I had something like tardive dyskinesia, but that passed. Probably seizures as well, just not so obvious.


More theory:


I'm not sure if this is correct: http://en.wikipedia.org/wiki/GABAA_receptor


The GABA-A receptor is a ligand-gated ion channel.

In short, an ion channel.

Clonazepam has serotonergic properties and also acts on GABAB. Very complicated, I could produce a lot of references, but what's the point ?

The serotonin receptors are G protein-coupled receptors (GCPRs).

Clonazepam seems to upregulate the serotonin transporter. (antidepressants usually do the opposite)

GABAB receptors are metabotropic transmembrane receptors.

Glutamate receptors are a different thing altogether. 'specialized integral membrane proteins'


Very different issues. Would it not be reasonable to assume that all receptors/issues adapt at varying speeds ?

I hesitate to use the word 'healing'. I don't think the real healing begins till one is off the drug.


I have a 'mixed' reaction to clonazepam. Sedating/stimulating, increasing appetite/sometimes energy metabolism etc. That DOES NOT make things easier !


That glutamate decarboxylase activity (increasing GABA) is a strange thing. Why would a benzo activate that enzyme and produce more GABA ?


In my experience, what clonazepam does is NOT proportional to the dose.

4 mg is not equal to 2 x 2 mg, 2 mg is not equal to twice 1 mg.

To what extent it's my body or the drug, I don't know. Probably both.

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I'm not trying to cheer you up I just want to make one factual point. Look at your post and how well they are put together and the research you've done...damaged brain? My doctor who is very benzo wise ( he had a 10 year battle with Valuim) says that a professor wrote a paper about the long term effects of benzos. His conclusion was that the use of benzos can cause mild to severe reversible abstract thinking.


You will heal! Why do I believe that, a lot more documentation to support that theory than someone becoming permentaly brain damaged by benzos!  :)

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The thing is, I haven't been able to stop taking this drug.


When I try to take less than 1 mg I can get all sorts of issues.


The drug or withdrawal doesn't make me stupid, but that's about it.

I did my research before I tried to taper.


Clonazepam is probably one of the worst drugs.

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