Published March 29, 2011
I am not a psychiatrist who reaches for a prescription pad within minutes of a patient arriving in my office. I believe deeply that people suffer emotionally because of stressful, traumatic life events that result in negative psychological, behavioral and even neurological fallout.
Yet, once that fallout is present, medication can be very helpful in stabilizing a person’s mood, anxiety or ability to think clearly, while the work unfolds of achieving insight into past events in that individual’s life.
One medicine I believe is being underutilized is clonazepam. Clonazepam (Klonopin) is a benzodiazepine anti-anxiety medicine, in the same category as medicines like Valium and Xanax. But, unlike those medications, I have found that clonazepam is less likely in my patients to promote long-term dependency and that it is especially effective in reducing symptoms of anxiety in the setting of depression, panic disorder and many other conditions.
Again, I am focused very clearly on examining patients lives with them, but when debilitating anxiety has kept them essentially housebound, or led them to contemplate suicide, or rendered them unable to work or even focus on psychotherapy, it mystifies me how they can so often arrive at my office (which they do) without any clinician having placed them on clonazepam. Not infrequently, beginning the medicine quickly and dramatically reduces their symptoms—sometimes in a single day, or just an hour.
One reason why clonazepam isn’t used more commonly than it is may be that serotonin reuptake inhibitors (SSRIs)—like fluoxetine (Prozac) and sertraline (Zoloft)—are newer and can be effective at treating symptoms of depression and anxiety. So doctors may feel that they are avoiding any potential for addiction by avoiding clonazepam, in favor of these agents. But I have found that serotonin reuptake inhibitors sometimes (not always) fall far short of the results that can be obtained with clonazepam. And the SSRIs take weeks to work.
Debilitating anxiety may very well be the leading cause of disabling psychiatric disorders. More and more, I realize it is at the core of what we think of as “agitated depression,” attention problems, and sleep problems. Sometimes these conditions make people quite desperate. And clonozepam can calm that desperation and allow them to focus on the issues fueling their symptoms.
Dr. Keith Ablow is a psychiatrist and member of the Fox News Medical A-Team. He is a New York Times best-selling author, and co-author, with Glenn Beck, of the book "The 7: Seven Wonders That Will Change Your Life". Dr. Ablow can be reached at firstname.lastname@example.org