Klonopin and Ativan as anti - manic medications

Klonopin and Ativan both make good anti anxiety medications, as they are Benzodiazepines.
Both Klonopin (clonazepam) and Ativan (lorazepam) also make decent mood stabilizers - anti manic medications, especially effective as add - on medications to certain antipsychotics and more established mood stabilizers.

There is evidence for both Lorazepam and Clonazepam being effective as primary antimanic agents, although Lorazepam may be superior in this respect (Bradwejn et al, 1990). However, concerns about provoking disinhibition, the risk of dependence and the lack of efficacy of benzodiazepines in the prophylaxis of bipolar disorder have limited the use of these medications.

There is growing and robust evidence for the use of benzodiazepines as an adjunctive treatment with mood stabilizers in acute mania. Lorazepam (Bowden et al, 1994) and clonazepam have been used successfully as adjunctive treatments in acute mania instead of neuroleptics. Lorazepam has the advantage of being available for parenteral use. Benzodiazepines are useful in the first few hours and days of the treatment of acute mania to suppress behaviour disturbance and tackle insomnia. It is becoming common practice to taper down and discontinue benzodiazepines within 2-3 weeks of achieving adequate symptom control in mania.

Bowden CL, Brugger AM, Swann AC, Calabrese JR et al 1994. Efficacy of Divalproex vs Lithium and Placebo in the Treatment of Mania. JAMA. 271:12. 918-924.

Bradjewn J, Shriqui C, Kosycki D et al. 1990. Double-blind comparison of the effects of clonazepam and lorazepam in acute mania. J Clin Psychopharm. 10. 403-408.

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Yes @firemonkey they are better as add - ons, they do not make good primary mood stabilizers.
I have always known that Clonazepam makes a pretty good mood stabilizer for me - it works. I also take a mood stabilizer - Lamictal and an antipsychotic - Risperdal for now


I just wanted to say I’m always grateful for the med knowledge you guys bring to the table and how simply you guys can explain what my doc takes a whole session to try and relay.

Thank you guys. I’ve gotten many ideas and options from your posts.