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.
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 ?