The benzodiazepines are a class of drugs typically prescribed for the treatment of anxiety or chronic seizure. They work by slowing the electrical activity in the brain, resulting in a sedative effect. Doctors may prescribe these drugs for brief or prolonged periods, or simply as needed—such as in the event of a panic attack. The potential adverse effects of benzodiazepines are fairly well understood by the medical community. People may experience drowsiness, headache, dizziness, and an unsteady feeling. High doses have an intoxicating effect similar to alcohol consumption.
However, the effect of chronic low doses of medications like Xanax (alprazolam) and Klonopin (clonazepam) on human tissue and organs is still to be determined. Previous studies have suggested that long-term administration of benzodiazepines may weaken the immune system, although no conclusive evidence of such a link exists.
A clinical experiment with rats tested the effects of Klonopin and Xanax on stressed and nonstressed male rats. The stress procedure involved confining the rats to a small mesh cage for 2.5 hours each morning. Some rats received Klonopin, some Xanax, and others only a control solution of distilled water. The study continued for four weeks, after which the rats were euthanized and the clinicians carefully examined them. The research team was most interested in the health of the immune system, and they primarily investigated lymph glands and blood cell counts. The findings have implications for the treatment of anxiety in humans.
Both stressed and nonstressed rats showed immune system deficits after treatment with either Klonopin or Xanax. Rats treated with Xanax demonstrated the most serious deficits, possibly because of the medication’s unique chemical structure. Because of the experimental design, researchers were able to distinguish between immune deficiencies caused by stress alone and those caused by medication. Nonstressed, medicated rats showed less decline than their stressed counterparts, but the decline was still clinically meaningful. It’s worth noting also that these rats received relatively low doses of medication. Continued administration beyond four weeks might reveal even more profound immune system effects.
These results argue for more caution when prescribing anti-anxiety medications. Both Xanax and Klonopin appear to degrade the immune system in distinct ways. Overall, Klonopin’s effects were less severe than those of Xanax, but were still worrisome. Patients with already compromised immune systems may want to avoid this class of medications if possible. Otherwise, Klonopin may be the safest choice. In addition, short-term use of the drug is definitely preferable to a long-term prescription.
References:
- Elmesallamy, G. E., Abass, M. A., Refat, N., and Atta, A. H. (2011). Differential effects of alprazolam and clonazepam on the immune system and blood vessels of non-stressed and stressed adult male albino rats. Interdisciplinary Toxicology, 4(3), 132-143.
- PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Alprazolam. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000807/
Children under severe psychological duress sometimes develop an involuntary reflex that causes them to swallow large volumes of air. Known as pathologic childhood aerophagia (PCA), this condition leads to a variety of stomach and intestinal problems if left untreated. Bowel distention, malabsorption of nutrients, and abdominal cramping are all potential symptoms of long-term PCA. Treatment of PCA usually consists of supportive counseling and reassurance, along with an attempt to identify and manage sources of stress and worry. Attending physicians may also prescribe anti-anxiety drugs on a case-by-case basis when the first line of treatment fails. Researchers in Korea performed a small-scale test to determine whether the anti-anxiety drug Klonopin (clonazepam) might be safe and effective in treating PCA.
Twenty-two children at a Korean clinic were enrolled in the PCA management study. Fifteen received Klonopin, and the other seven received counseling alone. Parents provided informed consent on behalf of their children, and there was no placebo-controlled group for comparison. Video observation of the children’s esophagus confirmed that abdominal symptoms were a result of PCA and not another condition. Throughout the study, regular observation with a videoscopic device helped clinicians determine the state of the child’s PCA. Children and parents also self-reported PCA symptoms and any potential medication side effects throughout the study.
Researchers dispensed Klonopin to the children at doses far below the normally therapeutic amounts. However, even at these low doses, empirical video evidence confirmed that the muscles controlling the involuntary swallowing action relaxed quickly after administration. The effective dosage of Klonopin in the study was low enough that long-term maintenance treatment presented relatively little risk. Children treated with Klonopin experienced remission of their PCA at a rate of 67%, compared with only 15% for children treated only with reassurance. In the absence of follow-up treatment, however, the likelihood of relapse was fairly high. A combination approach that incorporates both pharmaceutical and behavioral treatments offers the most comprehensive solution.
Except in cases of mental retardation, PCA is nearly always a symptom of psychological distress. Although Klonopin and similar psychotropic medications offer relief from the condition, cognitive therapy is important for maintaining remission and enhancing the individual’s self-confidence and coping mechanisms.
References
- PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Clonazepam. Retrieved April 4, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000635/
- Hwang, J., Kim, J. S., Ahn, B. H., Jung, C., Lee, Y. H., Kam, S. (2007). Clonazepam treatment of pathologic childhood aerophagia with psychological stresses. Journal of Korean Medical Science, 22, 205-208.