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Benzodiazepine — Long-acting

Clonazepam (Psychiatric Use)

Brand names: Rivotril

This monograph covers clonazepam used in a psychiatric context, where this long-acting benzodiazepine may be used short term for severe anxiety or agitation; it is not licensed as a first-line anxiolytic.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It potentiates GABA-mediated inhibition at the GABA-A receptor, producing anxiolytic, sedative and anticonvulsant effects.

Prescribing in practice

  • It carries a substantial risk of tolerance and dependence and should be reserved for short-term use, with any longer course tapered rather than stopped abruptly.
  • Concurrent opioids, alcohol or other CNS depressants greatly increase the risk of sedation and fatal respiratory depression.
  • Its long duration of action favours accumulation and daytime sedation, requiring caution and reduced dosing in the elderly and in hepatic impairment.

Monitoring

Monitor sedation, response, and for signs of tolerance or dependence, reviewing the need for continued treatment regularly.

Counselling the patient

  • This medicine can cause drowsiness and affect driving and concentration.
  • Avoid alcohol while taking it.
  • Do not stop it suddenly after regular use, as withdrawal effects can occur.

Evidence & guidelines

Benzodiazepines such as clonazepam are recommended for short-term use only because of dependence risk, in line with NICE and MHRA guidance.

Reference: NICE CG185 (Bipolar Disorder); NICE CG22 (Anxiety); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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