Is Clonazepam Effective for Managing OCD Symptoms?

Obsessive-compulsive disorder (OCD) is a common mental health condition characterized by unwanted and uncontrollable obsessions and compulsions. Obsessions are excessive and repetitive thoughts, fears, feelings, and urges that are upsetting, intrusive, sexual, violent, or frightening in nature. Compulsions involve rituals and routines that must be performed to alleviate the stress and anxiety causing the obsession. Compulsions are also unwanted, uncontrollable, and repetitive.

OCD impacts millions of Americans with this total increasing every year.

In recent years, OCD has become a popular punchline in reality shows (i.e., “Hoarders”), sitcoms, and movies, however, this condition is no joke. It is, however, a real condition that can wreak havoc on the sufferer’s life, health, and well-being. It is common for people with OCD to also suffer from panic attacks because this condition is anxiety-provoking. Unbeknownst to many, OCD is not monolithic. In fact, OCD is composed of many different subtypes, ranging from meta OCD and reading OCD to contamination OCD and hoarding OCD.

Because OCD has an anxiety component, people who suffer from it are sometimes prescribed clonazepam, or the brand name of the medication, Klonopin. However, one of the most common medications used to treat OCD is SSRI antidepressants. In fact, the first-line OCD treatments are psychotherapies, like cognitive-behavioral therapy (CBT), or exposure-response and prevention (ERP) therapy, and/or medications like SSRIs or SNRI depressants, tricyclic antidepressants, MAOIs, or antipsychotics.

Many OCD sufferers also turn to self-help tools, alternative treatments, and natural remedies like mindfulness, hypnosis, neurofeedback, art therapy, and an online OCD recovery treatment program like Impulse Therapy. OCD support groups, forums, podcasts, books, and Reddit groups are also often used to supplement prescribed OCD treatments. However, when these OCD treatments are ineffective, other methods are used – other methods like clonazepam.

If you are wondering what clonazepam is and if and how it could work for your type of OCD, you are in luck, because with this article you will learn if this medication may be a viable option for you.

What is Clonazepam?

Clonazepam, the generic name for Klonopin, is a benzodiazepine (anticonvulsant). Researchers suggest that benzodiazepines work by boosting serotonin, a neurotransmitter, in the brain. Studies indicate that people with mental health conditions, like OCD, tend to have low levels of serotonin in their brains (a serotonin deficiency). Clonazepam is designed to restore serotonin (to a healthy level) in the brain. 

This medication is FDA-approved to treat seizure disorders (i.e., absence seizures and Lennox-Gastaut syndrome) in adults and children. However, it is also used “off-label” to treat anxiety conditions like post-traumatic stress disorder (PTSD), panic disorder/panic attacks, and OCD.

What Are The Side Effects of Clonazepam?

All medications come with the possibility of side effects, and clonazepam is no exception. Clonazepam comes with a host of possible side effects, ranging from mild to severe. If these symptoms worsen or persist, contact your doctor, call 911, or go to your nearest Urgent Care or hospital.

These side effects include:

• Addiction
• Hives
• Breathing difficulties (slowed, weak, shallow, delayed, or rapid breathing)
• Swollen face, lips, tongue, and/or throat 
• Blue-colored lips
• Inability to awaken
• Sudden mood swings and/or uncharacteristic behaviors
• Acute or chronic Depression or Anxiety
• Panic Attacks
• Insomnia
• Impulsivity
• Irritability
• Agitation
• Hostility
• Aggression
• Restlessness
• Excessive chattiness
• Suicidal ideation (thoughts or attempts)
• Seizures
• Extreme drowsiness
• Mental confusion
• Paranoia
• Nightmares or night terrors
• Hallucinations or delusions
• Urges to self-harm 
• Unusual or involuntary eye movements
• Dizziness
• Memory problems
• Mobility or coordination problems
• Unusual muscle movements
• Cognitive issues
• Ringing in the ears
• Burning or prickly sensation or a crawling feeling under the skin

How Much Clonazepam is Needed for OCD?

Clonazepam comes in the following strengths: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, and 2 mg tablets. However, 1-4 mg of clonazepam is typically needed, per day, to ease or control OCD symptoms. Understand, however, that clonazepam dosages are based on weight. Swallow the tablet whole with an 8 oz. glass of water.

If you have been prescribed an orally disintegrating tablet only remove the tablet out of its packaging when you are ready to take it. Place the tablet under your tongue and allow it to disintegrate. Do not chew or suck on it. Swallow several times until the tablet has completely dissolved. If you decide to take clonazepam for OCD, you will need frequent labs (i.e., bloodwork).

Note: Do not stop taking clonazepam once you begin to feel “better” because if you do, you risk experiencing clonazepam withdrawal symptoms (i.e., seizures) and/or an OCD relapse. Alert your doctor if you start to experience seizures or panic attacks while on this medication.

How Does Clonazepam Work For OCD?

As mentioned previously, the most common medicine for OCD is SSRI antidepressants like Prozac. Unfortunately, however, sometimes this class of OCD medications is ineffective or riddled with side effects and complications, rendering it a poor choice for treatment. When the traditional OCD medications do not work, other medications are considered. One of these options is clonazepam (Klonopin). Researchers have found that people, who experience treatment-resistant OCD, may benefit from benzodiazepines like clonazepam.

However, this medication comes with a host of side effects, including addiction. The jury is also still out when it comes to its long-term effectiveness in the treatment of OCD. When SSRIs and other anti-anxiety medications are not a viable option, a treatment protocol involving a combination of psychotherapy and benzodiazepines like clonazepam may be the next course of action.

Does Clonazepam Work For All “Types” of OCD?

Yes, it does.

Because a hallmark cause and symptom of OCD is anxiety, clonazepam is likely to work on all “types” of OCD. More specifically, all types of OCD involve stress and anxiety, and studies indicate that clonazepam is highly effective for reducing and eliminating anxiety, it makes sense that clonazepam would also work for all “types” of OCD. 

Also, according to studies, clonazepam is especially effective for OCD sufferers who also struggle with panic attacks or panic disorder. Ironically, however, although research suggests that this medication is highly effective for anxiety, the same can not be said about OCD. In other words, study results are mixed when it comes to how effective clonazepam is for other aspects of OCD.

Can Clonazepam Work For OCD Comorbidities?

Yes, it can.

OCD is linked to many different comorbidities. What does that mean? It means that OCD is linked to other mental health conditions, such as OCD and depression, OCD and ADHD, OCD and panic disorder/panic attacks, OCD and anxiety, OCD and PTSD, etc. Remember, studies indicate that clonazepam can ease anxiety and panic attacks, which is why it is sometimes prescribed for OCD.

However, it appears to be most effective when it is prescribed to OCD sufferers who also struggle with other anxiety conditions like panic disorder/panic attack, post-traumatic stress disorder (PTSD), generalized anxiety, social anxiety, etc. Most OCD sufferers, who use clonazepam, take it daily or PRN “as needed.” Why? Because of its addictive properties. This medication can produce a “high” sensation that is also “numbing,” which is appealing to people with OCD. The problem is that this “euphoric effect” is only temporary, leading to more and more of it to maintain the desired effect.

Clonazepam works for OCD by “calming down” hyperactive brain activity – it is this excessive brain activity that can trigger anxiety and it is this anxiety that can trigger OCD. If the brain is “calm” and “stable,” OCD sufferers are less likely to experience anxiety, which means they are also less likely to experience obsessions and compulsions.

Clonazepam also boosts the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a nerve cell chemical that connects information together. In those with slightly hyperactive brain activity, clonazepam may only be used short-term, however, for those with extremely hyperactive brain activity, this medication may need to be taken daily to reduce, alleviate, or prevent hyperactive brain activity.

Note: Studies suggest that clonazepam alone is not particularly effective for OCD.

What Does The Research Say?

Listed below are research findings on using clonazepam for OCD:

According to a previous study, people who take clonazepam for OCD may experience a rapid onset of anti-obsessive effects like reduced anxiety and depression. In fact, researchers found that OCD sufferers, who take this medication for their OCD symptoms, report experiencing a reduction in the severity and frequency of the obsessions and compulsions.

This improvement was greater with clonazepam than with clomipramine, a tricyclic antidepressant used to treat OCD. Thus, researchers have concluded that clonazepam may be a viable treatment option for OCD sufferers who have been unable to get relief from other OCD treatments, namely CBT or ERP therapy, and/or SSRIs. Researchers also found that clomipramine and clonazepam were equally effective when used to ease or alleviate OCD symptoms.

Similarly, previous research indicates that OCD sufferers, who suffer from OCD and an anxiety disorder, like OCD and panic disorder, whose OCD and panic attacks, may experience a reduction in obsessions and compulsions after using this medication. Researchers also found that clonazepam may alleviate these OCD symptoms rapidly and efficiently, which is unlike other OCD medications, like SSRIs and other antidepressants, that can take 4-6 weeks to work.

Conversely, a 2016 study found benzodiazepines, like clonazepam, are relatively ineffective alone (38%) in the treatment of OCD. However, when clonazepam is combined with other medications, like SSRIs, the effectiveness improves (97%). Researchers also found that OCD symptoms did not abate until they were treated with a clonazepam/SSRI medication combo for months. This suggests that OCD with marked anxiety may be harder to treat with benzos, like clonazepam, than previously thought.

Likewise, research suggests that clonazepam is an ineffective OCD mono-treatment. This medication has shown effectiveness in certain OCD comorbidities, such as OCD and anxiety disorders, and as a supplement to SSRIs.

Reviews

The best way to get a real-life view of what it is like to take clonazepam for OCD. 

Listed below are clonazepam reviews on what it is like to take this medication for OCD.

• “Clonazepam nearly cost me my life. Avoid it at all costs. It is highly addictive and you will need more and more of it to not go into extreme physical withdrawals. Many people have died because of this class of OCD/anxiety drugs.”

• “I had a major OCD meltdown last week that left me with a post-trauma reaction basically and my doctor gave me some clonazepam to help me through the trauma reaction and to mitigate the next meltdown I have. I’m really going to try not to become too dependent on it but I just feel so good I’m actually happy and not worried. I actually slept like a baby last night. It’s definitely not a long-term solution for OCD. I’m going to only use it on bad days I think.”

• “Clonazepam treats anxiety, and so you may be feeling a decrease in anxiety or general numbness depending on how much you take, but that is different from addressing OCD symptoms. I have been on a combination of Prozac and clonazepam for years. I have not had the need to increase the dosage or face withdrawals, etc., but I don’t think clonazepam is a viable treatment for OCD. The euphoric effects will wear off. It might continue to help with panic attacks related to OCD, but these aren’t meds for OCD.”

• “Clonazepam has helped me tremendously with ruminating thoughts and the anxiety/panic that comes alongside it. I have had no tolerance, no withdrawals when I go without taking it for a while. I have also had no negative side effects, except getting a bit sleepy for a little while, which at first was a bit off-putting, but now feels a bit cozy if it ever happens.”

• “I think Klonopin is better than Valium for easing my stress and anxiety. Klonopin stays in your body longer than other types of anxiety medicines. I use it for my panic disorder, and it has been a godsend. However, it doesn’t really work for my OCD symptoms – not long-term anyway. Still, it has helped me relax and breathe easier.”

• “Benzos, in general, will help out your OCD for the time being. But I should warn you, there’s a reason that most medical professionals generally don’t prescribe benzos as a long-term treatment for OCD. There’s the whole issue of tolerance, dependence, addiction, etc. So, if I was you, I’d hang on to them and take one when you’re really feeling anxious or having trouble controlling your OCD symptoms. But in the meantime, I’d really look into behavioral therapy in combination with an SSRI.”

Final Thoughts

Clonazepam, also referred to as a “benzo,” is increasingly being used to treat OCD when all other methods and medications have failed. Although clonazepam appears to be effective for anxiety conditions, research suggests it is ineffective for OCD when it is used alone and just for OCD (all types of OCD), studies suggest that it may be effective for OCD comorbid conditions like OCD and anxiety disorders, especially OCD and panic disorder/panic attacks. This is because clonazepam is designed to ease or alleviate anxiety.

Because a precursor and symptom of OCD is anxiety, the belief is that this medication can ease the anxiety that is triggering OCD, thereby reducing the risk of obsessions and compulsions. But even though this medication can help OCD sufferers experiencing anxiety, it comes with a host of side effects, one of which is addiction. Therefore, it should only be used occasionally or PRN, if possible. Because of clonazepam’s side effects, risk of addiction, and ineffectiveness, this medication must be used with caution and close medical supervision.

Clonazepam should only be used in cases of treatment-resistant OCD. However, if you have tried traditional OCD treatments or specific medications, and you have been unable to tolerate them, or if other OCD medications have been ineffective, taking clonazepam may be worth a try. If you are thinking about taking this medication for your OCD, discuss the pros and cons of taking it with your doctor and family.

References

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• Hewlett, W. A., Vinogradov, S., & Agras, W. S. (1992). Clomipramine, clonazepam, and clonidine treatment of obsessive-compulsive disorder. Journal of Clinical Psychopharmacology, 12(6), 420–430. Retrieved from https://pubmed.ncbi.nlm.nih.gov/1474179/
• Starcevic, V., Berle, D., do Rosário, M. C., Brakoulias, V., Ferrão, Y. A., Viswasam, K., Shavitt, R., Miguel, E., & Fontenelle, L. F. (2016). Use of benzodiazepines in obsessive-compulsive disorder. International Clinical Psychopharmacology, 31(1), 27–33. Retrieved from https://doi.org/10.1097/YIC.0000000000000100
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• Bodkin, J. & White, K. (1989). Clonazepam in the treatment of obsessive-compulsive disorder associated with panic disorder in one patient. The Journal of Clinical Psychiatry, 50, 265-6. Retrieved from https://www.researchgate.net/publication/20418267_Clonazepam_in_the_treatment_of_obsessive_compulsive_disorder_associated_with_panic_disorder_in_one_patient
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