Klonopin and lexapro (A Complete Guide)

In this blog post, we are going to talk about the concomitant use of Klonopin and lexapro. We will also cover why these medications are used together and how to use them properly to ensure maximum therapeutic response and safety. 

Can you use Klonopin and Lexapro together? 

Yes, klonopin (Clonazepam) and lexapro (Escitalopram) are used together for the treatment of comorbid depression and anxiety. This combination is often prescribed by healthcare professionals to calm your anxiety down, while your antidepressant takes its time to start working in your system. 

Why are Klonopin and lexapro used together? 

Klonopin (Benzodiazepines) and lexapro (SSRIs) are used to control multiple overlapping symptoms of anxiety and depression. These symptoms include:

• Restlessness 
• Extreme distress
• Irritability 
• Suicidal behavior 
• Inability to engage in daily life activities 
• Weight loss or gain, depending on the effect of the condition on eating habits
• Excessive sweating 
• An urge to get isolated
• Hopelessness 
• Worthlessness 
• Confusion 
• Social disconnection 

Klonopin is a benzodiazepine. It is used to help control anxiety, convulsions and panic attacks. This medication basically acts like inhibitory chemicals in your brain to control the excessive neuronal activity. 

Lexapro, on the other hand, is an antidepressant. It is a selective serotonin reuptake inhibitor (SSRI) and is used to treat mild to severe episodes of depression and generalised anxiety disorder. 

Lexapro inhibits the reuptake of serotonin by blocking serotonin transporters (SERT). This results in increased serotonergic activity. Lexapro and every other antidepressant take time to kick in. 

They don’t work overnight and your body may take up to 8 weeks to adjust to the medicine. This is exactly why it’s said that antidepressants might make you feel worse before making you feel better. 

Klonopin, when prescribed together, controls this anxiety. It does not need weeks to kick in and can start working after an hour or two of administration. 

Safety concerns with the use of Klonopin and lexapro together 

Both Klonopin and lexapro are associated with few side effects, which can vary from person to person. 

The concomitant use may increase the risk of drowsiness, low mental alertness, impaired motor functions, confusion, forgetfulness etc, but these side effects depend on the doses you’re at. 

Side effects are not just the effects of your drug but also how your body responds to the drug. Usually Klonopin is well tolerated, but some people may suffer from the side effects and might even stop the treatment because of them. 

It depends on the pre-existing health conditions as well. One of the side effects of benzodiazepines include respiratory depression, which is dose dependent. 

A person with normal respiratory function might not even notice this side effect on the normal therapeutic dose, but people with chronic breathing disorders like asthma, chronic obstructive pulmonary disease (COPD) and emphysema etc, can suffer from significant breathing difficulties. 

Similarly, lexapro is considered safe to be used in cardiac patients, but it could cause QT elongation and make pre-existing arrhythmia even worse. Klonopin is also known for causing an addiction, which is why it is not suitable for prolonged use. 

Doctors usually recommend using it as long as your antidepressant kicks in. After that, both anxiety and depression can be managed by lexapro and Klonopin is slowly tapered off. You see, it’s not always about the drug, but also your body’s reaction to it. 

Both pharmacodynamics (how a drug affects your body) and pharmacokinetics (how your body affects a drug) are considered. 

It is always best to consult your healthcare provider and be certain that the combination of meds you’re about to use is compatible with any underlying health condition you might have. It is also important to make sure that all of your meds are compatible with one another. 

How much is too much? 

The doses at which you’re taking Klonopin and lexapro play the most important rule in safety and efficacy profile of the concomitant use of these meds. High doses of both the meds can make you vulnerable to CNS side effects. 

Klonopin is very potent and low doses are sufficient to provide therapeutic response. In usual practice, 0.5 mg Klonopin should be enough to control your anxiety, till your lexapro kicks in, which is also started with a lowest effective dose. 

Usually 10 mg is prescribed. Make sure you don’t take more than your healthcare professional has recommended. Higher doses will lead to much more pronounced drowsiness, dizziness and mental confusion. 

The timing at which you take your medications also makes a huge difference. Usually, it is recommended to take your lexapro in the morning (if it does not cause tiredness or sleepiness) and your Klonopin at bedtime, as it induces sleep and slows down your brain.

If these timings do not suit you or you take both of these at bedtime and still feel lethargic and tired during the day, talk to your doctor. 

Your doctor may weigh the pros and cons of this concomitant treatment in accordance with your side effects and will determine if it’s worth continuing it. 

Precautions to take if the concomitant use of Klonopin and lexapro makes you sleepy during the day. 

Make sure you avoid certain activities when the concomitant use of these two meds make you feel sleepy or tired during the day time. These activities include:

Driving 

Do not drive when you’re feeling tired or drowsy. Driving requires your full physical and mental alertness and it’s in your best interest to avoid it when you’re tired and have low energy levels. If there’s somewhere you need to be, just ask a friend to drop you or book a ride. 

Driving without full mental alertness can cause accidents. It not only puts you in danger, but others around you as well. Make sure you stay out of trouble. 

Operating machinery 

If you’re an employee in some factory where you are supposed to operate heavy machinery, don’t! Your drowsiness might cause an accident and can make you or others around you severely injured. 

Drinking alcohol or taking any sedative

Make sure you’re not taking any other medication that might be contributing to your drowsiness. Do not drink alcohol, or you’ll end up dulling your senses even more. 

Alcohol itself is responsible for causing fatigue and drowsiness. It clouds your mind and messes up with your mental alertness and it would make a life threatening combination with Klonopin and lexapro. 

Key points to help ensure the proper use. 

• Immediately talk to your healthcare provider if you experience unusual side effects while taking Klonopin and lexapro together. 

• Do not recommend this combination to someone else and use it as long as your doctor has advised. 

• Inform your doctor if you’re pregnant, trying to conceive. Klonopin should not be used by pregnant women and lexapro can also be dangerous for the fetus, especially when used in the third trimester. 

• Inform your doctor if you’re a breastfeeding mother. Both of these drugs are capable of passing into the breastmilk and may cause side effects in newborns. 

• Lexapro may induce suicidal behavior in users younger than 24 years of age. If you have someone who shows suicidal behavior or you see hopelessness in them, make sure you keep an eye on them and get medical attention as soon as you can. 

• Do not stop Klonopin or Lexapro abruptly. If it’s time for you to stop one or both of these meds, your doctor will simply recommend a taper schedule for you, which should be followed vigilantly if you wish to keep withdrawal symptoms at bay. 

• Report any problems with bleeding or bruising to your doctor. If you see any unexplained blisters or rashes on your body, or experience any problems with urination, or if you feel changes in your vision, immediately report to your healthcare provider. 

Conclusion 

In this blog, we discussed the concomitant use of Klonopin and lexapro. These two agents are often prescribed together for the treatment of comorbid depression and anxiety. 

This combination can help calm your anxiety down, while your antidepressant takes its time to start working in your system. Both Klonopin and lexapro are associated with few side effects, which can vary from person to person. 

The concomitant use may increase the risk of drowsiness, low mental alertness, impaired motor functions, confusion, forgetfulness etc, but these side effects depend on the doses you’re at. High doses of both the meds can make you vulnerable to CNS side effects. 

Klonopin is very potent and low doses are sufficient to provide therapeutic response. In usual practice, 0.5 mg Klonopin should be enough to control your anxiety, till your lexapro kicks in. 

Lexapro is also started from the lowest effective dose as not everyone can tolerate lexapro well. Antidepressants are quite tricky and there’s a chance that lexapro might not work for you. You may need to try a few more antidepressants to find which one is the right choice for you.

Klonopin is usually tolerated well and it does not need weeks to start working because of its rapid onset of action. 

FAQs: klonopin and lexapro 

Can clonazepam be taken with Lexapro?

Yes, you can take clonazepam and lexapro together. The combination can be used to treat comorbid depression and anxiety. 

Can Lexapro increase anxiety?

Lexapro may increase anxiety during the first few weeks of your treatment. This effect is common because antidepressants take some time to kick in and may make you feel worse and anxious before starting to make you feel better. 

What drugs should not be taken with clonazepam?

• Antifungals and antivirals. They may inhibit the metabolism of clonazepam and cause toxicity. 
• Antiepileptics. The concomitant use may decrease the beneficial effects of clonazepam. 
• Anti-allergy medications. The concomitant use increases the risk of sedation 
• Narcotic analgesics or any other controlled substance. The concomitant use can cause serious CNS side effects. 
• Sleeping pills
• Other anxiolytics and tricyclic antidepressants (TCAs). 

What can you not mix with Lexapro?

Do not take lexapro with:

• Monoaminoxidase inhibitors (MAOIs). The combination use can increase the risk of serotonin syndrome. 
• Non-steroidal anti-inflammatory drugs (NSAIDS). The combination use can increase the risk of bleeding. 
• Pimozide. The concomitant use can increase the plasma concentration(availability of a drug in the blood) of pimozide to much higher levels. It can result in life-threatening arrhythmia.
• Controlled substances, including all narcotic analgesics. The concomitant use can cause severe psychological side effects. 
• Mood stabilisers 
• Alcohol 

How long does it take clonazepam to work for anxiety?

Clonazepam typically takes an hour to start producing its effects. It has a faster onset of action and a half life of about 30 to 40 hours. 

Does clonazepam stop panic attacks?

Yes, clonazepam can stop panic attacks. This medication mimics the inhibitory neurotransmitters like GABA in our system and stops the excessive neuronal firing which is associated with panic attacks, as well as seizures. 

References 

• Boadie W. Dunlop, M.D. and Paula G. Davis, Ph.D. (2008) – Combination Treatment With Benzodiazepines and SSRIs for Comorbid Anxiety and Depression: A Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/#__ffn_sectitle
• Shigeru Morishita. Hum Psychopharmacol. (2009) – Clonazepam as a therapeutic adjunct to improve the management of depression: a brief review https://pubmed.ncbi.nlm.nih.gov/19330803/ 
• Drug Interactions between Klonopin and Lexapro https://www.drugs.com/drug-interactions/klonopin-with-lexapro-703-357-1013-565.html#:~:text=Interactions%20between%20your%20drugs&text=Using%20clonazePAM%20together%20with%20escitalopram,%2C%20judgment%2C%20and%20motor%20coordination.