2010 Mar 20;196(1-3):14-7. doi: 10.1016/j.forsciint.2009.12.037. [89][91], Doses higher than 0.51mg per day are associated with significant sedation. sharing sensitive information, make sure youre on a federal Urine samples with such a low creatinine level are less concentrated, and urine drug concentrations may fall below the reporting threshold in such samples. These values do not apply to results that are converted to other units of measure. Further information regarding specimen tampering is available in the Aegis Clinical Reference Guide at https://www.aegislabs.com/resources/clinical-reference-guide/. [133], A 2006 US government study of hospital emergency department (ED) visits found that sedative-hypnotics were the most frequently implicated pharmaceutical drug in visits, with benzodiazepines accounting for the majority of these. 0000001552 00000 n 12% 38% 41% 1% 8% Fig. Further information regarding specimen stability is available in the Aegis Clinical Reference Guide at https://www.aegislabs.com/resources/clinical-reference-guide/. Clonazepam (CLON) is not only frequently prescribed in addiction management but is also commonly abused. 2004 Oct 29;145(2-3):123-30. doi: 10.1016/j.forsciint.2004.04.066. Clonazepam in particular is more prone to stability issues. is a metabolite of the drug clonazepam (Klonopin) a central nervous system depressant of the benzodiazepine class. You should be aware if anyone is using it improperly or without a prescription. Point of Care Testing ConsiderationsSome point-of-care testing (POCT) devices may result in a false positive for benzodiazepines in patients who are taking certain medications.6,11-17 Cross reactivity can occur with this type of testing among drugs with similar chemical structures.11 Non-benzodiazepine prescription, illicit, or over-the-counter drugs would not cause a false positive for benzodiazepines or benzodiazepine metabolites on Aegis definitive testing. Comparison of Clonazepam Compliance by Measurement of Urinary [29], Restless legs syndrome can be treated using clonazepam as a third-line treatment option as the use of clonazepam is still investigational. Clin Chim Acta. 2017;20:SE1-9.21. Version 2.73 51776-37-Aminoclonazepam [Mass/volume] in Urine by Confirmatory methodActive Part Description LP28541-8 7-Aminoclonazepam 7-Aminoclonazepam is a metabolite of clonazepam, a benzdiazepine drug used to treat or control seizures, panic attacks, and akathisia. It differs from other anticonvulsant drugs it was compared to in a study. Medically reviewed by Kaci Durbin, MD. Read the medication guide or patient instructions provided with each medication. [75][76] One-third of individuals treated with benzodiazepines for longer than four weeks develop a dependence on the drug and experience a withdrawal syndrome upon dose reduction. Version: 10.01. gabapentin, sertraline, alprazolam, fluoxetine, lamotrigine, Zoloft, Xanax, pregabalin, diazepam, Prozac. As a result, drugs present at therapeutic concentrations may not always be detected. Use in very young children may be especially hazardous. and phenytoin. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. 7AC should be the analyte measured in OF for the detection of CLON use. startxref Click on the title Specimen Validity Testing and Specimen Tampering to download a copy of this chapter. J Anal Toxicol. A gradual reduction in dosage reduces the severity of the benzodiazepine withdrawal syndrome. Snyder ML, Fantz CR, Melanson S. Immunoassay-based drug tests are inadequately sensitive for medication compliance monitoring in patients treated for chronic pain. Keep track of your medicine. Accessibility Instability of 7-aminoclonazepam in frozen storage conditions One volunteer had the highest concentration of 7-ACLO at 3 days, two volunteers at 5 days, and one at 8 days. [33], In September 2020, the U.S. Food and Drug Administration (FDA) required the boxed warning be updated for all benzodiazepine medicines to describe the risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions consistently across all the medicines in the class. Bioanalysis. Stamford, CT: PharmaCom Group, Inc.; 2015:1-32.12. You may have this test if it's possible you have taken an overdose of clonazepam. [9], The elderly are especially susceptible to increased risk of harm from motor impairments and drug accumulation side effects. 8600 Rockville Pike It may also be used to treat panic attacks, insomnia, and generalized anxiety. In addition, BZ are highly protein bound, reducing the free fraction of . Unauthorized use of these marks is strictly prohibited. J Chromatogr B Analyt Technol Biomed Life Sci. . The period of detection for benzodiazepines varies greatly according to the specimen type utilized for testing and the patients dosing regimen. [123], Clonazepam is a 2'-chlorinated derivative of nitrazepam, which increases its potency due to electron-attracting effect of the halogen in the ortho-position. Clonazepam's mode of action is to decrease abnormal electrical energy in the brain. 2023 University of Rochester Medical CenterRochester, NY, Clinical and Translational Sciences Institute, Monroe County Community Health Improvement Plan. Alprazolam (Xanax): Metabolizes to alpha-hydroxyalprazolam; reported as Alprazolam Clonazepam (Klonopin): Metabolizes to 7-aminoclonazepam; reported as Clonazepam Flurazepam: Metabolizes to 2-hydroxyethylflurazepam; reported as Flurazepam Lorazepam (Ativan): Metabolizes to lorazepam glucuronide; reported as Lorazepam 0000006281 00000 n But be sure your healthcare provider knows 11th ed. Stopping suddenly may cause increased seizures or unpleasant withdrawal symptoms. children who suffer from partial seizures and spasms. 2009;1(5):937-52.13. In general, the following guidance may be helpful: Positive for alprazolam and alpha-OH-alprazolam, Write in Other field(Paper Requisition). 7-Aminoclonazepam. ETHANOL <10 mg/dL ethanol reported as negative, Last updated 2023-02-02T16:38:32.834115+00:00, Contact: commserv@uw.edu | Immunoassay. In OF the levels of 7AC were approximately 2.4-fold higher than CLON. Never use this medicine in larger amounts, or for longer than prescribed. Clonazepam may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. It can cause side effects such as drowsiness . In some individuals, however, peak blood concentrations were reached at 48 hours. In blood, especially, the period of detection is generally limited to very recent use. In many cases, non-pharmacological treatments, such as relaxation therapy, psychotherapy, and avoidance of caffeine, can be an effective and safer alternative to the use of benzodiazepines for anxiety in pregnant women. Our series on interpreting unexpected results concludes with a discussion on the interpretation of benzodiazepine results from Aegis Sciences Corporation. This is a substance your body makes from clonazepam. Determination of bromazepam, clonazepam and metabolites after a single intake in urine and hair by LC-MS/MS. 2016 Mar;95(9):e2881. Int J Spectrosc. Drug classes: Benzodiazepine anticonvulsants, Benzodiazepines. Moosmann B, Link LA, Auwarter V. Designer benzodiazepines: a new challenge. FOIA Providers should use their independent medical judgment based on the clinical needs of the patient when making determinations of who to test, what medications to test, testing frequency, and the type of testing to conduct. Some withdrawal symptoms may last up to 12 months or longer. Please enable it to take advantage of the complete set of features! J Anal Toxicol. Clipboard, Search History, and several other advanced features are temporarily unavailable. 7-aminoclonazepam is superior to clonazepam for detection of - PubMed -7-Aminoclonazepam (metabolite of clonazepam)-Diazepam (separate prescribable drug and . [135], In some countries, clonazepam is used by criminals to subdue their victims. If the patient reports a recent hospitalization or emergency department visit, follow-up with the hospital may be necessary to determine what medications were administered to the patient. Reisfield GM, Goldberger BA, Bertholf RL. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. HHS Vulnerability Disclosure, Help Preventing seizures may outweigh these risks. 2009;186:81-510. The concentration ranges of clonazepam+7-aminoclonazepam were 0.002-0.840 mg/kg (median 0.067) for traffic cases, 0.005-0.913 (median 0.071) for criminal cases (offenders), 0.002-0.720 (median 0.030) for criminal cases (victims) and 0.002-1.676 (median 0.115) for postmortem cases. Clin Chim Acta. Keep the medication in a place where others cannot get to it. Other drugs were present in all cases, with clonazepam judged to be the primary cause of death in five cases. Please enable it to take advantage of the complete set of features! 2023 Jan 23:1-13. doi: 10.1007/s40264-022-01269-x. The use of clonazepam during pregnancy should only occur if the clinical benefits are believed to outweigh the clinical risks to the fetus. Kempf J, Wuske T, Schubert R, Weinmann W. Pre-analytical stability of selected benzodiazepines on a polymeric oral fluid sampling device. Clonazepam, like other benzodiazepines, while being a first-line treatment for acute seizures, is not suitable for the long-term treatment of seizures due to the development of tolerance to the anticonvulsant effects. Benzodiazepine metabolism: an analytical perspective. An official website of the United States government. HHS Vulnerability Disclosure, Help In addition, it is frequently used to treat drug addicts and is itself a popular drug of abuse. [102] It consists of screening immunoassays for several drugs or drug classes, a quantitative enzymatic assay for ethanol and a gas chromatography-mass spectrometry (GC/MS) assay for a wide variety of therapeutic and abused drugs, as listed below. m@6lm -"`uX. [10] In 2020, it was the 44th most commonly prescribed medication in the United States, with more than 14million prescriptions. [10] However, CLON and other benzodiazepines can be challenging to detect in OF due to their weakly acidic nature and their presence in low concentrations. Result LOINC Value. Results from such tests can be used to confirm the diagnosis in potential poisoning victims or to assist in the forensic investigation in a case of fatal overdosage. stinging sensation or pain. In these cases, the claimed sensitivity is inadequate to detect the presence of the drug in urine even after an overdose. Accessibility Deliberate Self-Poisoning: Real-Time Characterization of Suicidal Habits and Toxidromes in the Food and Drug Administration Adverse Event Reporting System. Prescription: Benzodiazepines are controlled substances, and legitimate prescriptions would show up on the prescription drug monitoring program (PDMP) in most cases. [9], There is some medical evidence of various malformations (for example, cardiac or facial deformations when used in early pregnancy); however, the data is not conclusive. [89] Clonazepam is generally not recommended for use in elderly people for insomnia due to its high potency relative to other benzodiazepines. Contact the laboratory with any questions about the cross-reactivity of any specific drug with this assay. Copyright 1996-2023 Cerner Multum, Inc. These government site. [44], The long-term effects of clonazepam can include depression,[9] disinhibition, and sexual dysfunction.[70]. Clonazepam Antibody - EastCoast Bio Clonazepam is not approved to treat panic disorder in anyone younger than 18 years old. The https:// ensures that you are connecting to the Your healthcare provider may also order other tests, including: 7-aminoclonazepam. 0000008084 00000 n This benzodiazepine was chosen because it forms one major metabolite, 7-aminoclonazepam which is specific for that drug. Clonazepam was the second most frequently implicated benzodiazepine in ED visits. Dizziness or drowsiness can cause falls, accidents, or severe injuries. As a major metabolite, 7-aminoclonazepam may be used to monitor use of the parent drug, clonazepam. Is the patient on dialysis?If testing a dialysis patient, testing prior to dialysis is recommended or at least on a non-dialysis day to reduce the possibility of unexpected negative results. Nordal K, iestad EL, Enger A, Christophersen AS, Vindenes V. Ther Drug Monit. Washington, D.C. AACC Press;2013:149-69.15. Hart BJ, Wilting J, de Gier JJ. Version 2.73 28073-57-Aminoclonazepam [Mass/volume] in UrineActive Part Description LP28541-8 7-Aminoclonazepam 7-Aminoclonazepam is a metabolite of clonazepam, a benzdiazepine drug used to treat or control seizures, panic attacks, and akathisia. Residual effect of a 7-amino metabolite of clonazepam on GABAA - PubMed panic attacks, insomnia, and generalized anxiety. 2022 Oct 31;12(11):945. doi: 10.3390/bios12110945. 20225) is a certified reference material categorized as a benzodiazepine. Urinary analyses of the metabolite 7-aminoclonazepam (7-AC) can be helpful in monitoring drug abuse and in the context of suspected drug-facilitated sexual assaults (DFSA). 1A Detection frequency NPS TID Prescription/OTC DSS P/A/I 27% 12% 55% 2% 4% Fig. 2016;40:97-107.18. Accessibility Your test results may be different depending on the lab used. Detection of Nitrobenzodiazepines and Their 7-Amino Metabolites in Oral Fluid. Both clonazepam and 7-aminoclonazepam break down easily. 7-Aminoclonazepam is superior to clonazepam for - ScienceDirect Epub 2016 Mar 23. 8600 Rockville Pike LC-MS/MS extends the range of drug analysis in pain patients. Hegstad et al. [103], Combined use of clonazepam with certain antidepressants, anticonvulsants (such as phenobarbital, phenytoin, and carbamazepine), sedative antihistamines, opiates, and antipsychotics, nonbenzodiazepines (such as zolpidem), and alcohol may result in enhanced sedative effects. 2013 Dec 31;2013:245376. doi: 10.1155/2013/245376. These data illustrate the limitations of using a 200 ng/ mL cutoff to monitor clonazepam compliance and suggest that a cutoff of 40 ng/mL or less is needed to reliably monitor use of this drug. 0000001057 00000 n The challenges of LC-MS/MS analysis of opiates and opioids in urine. Clonazepam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). Clin Infect Dis. Comparison of Two Highly Sensitive Benzodiazepine Immunoassay Lab Considerations for Interpreting Unexpected Results. about all the medicines, herbs, vitamins, and supplements you are taking. Before Six of the volunteers had urine concentrations of 7-ACLO that peaked at 1 day after administration. Clonazepam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). Are there concerns with drug and sample stability such as improper storage or delays in shipment? Prolonged excretion of 7-aminoclonazepam in urine after - PubMed Azole antifungals, such as ketoconazole, may inhibit the metabolism of clonazepam. The assay can be run on miscellaneous pills, powders and liquids to identify a suspected ingested substance that a patient might arrive with at the hospital, and in this case, only the GC/MS assay is performed. The concentrations were thus similar among the groups, although the median value was highest in the postmortem group. Place the tablet in your mouth and allow it to dissolve, without chewing. Some long-term trials have suggested a benefit of clonazepam for up to three years without the development of tolerance but these trials were not placebo-controlled. [85] The combination of clonazepam and certain barbiturates (for example, amobarbital), at prescribed doses has resulted in a synergistic potentiation of the effects of each drug, leading to serious respiratory depression. Using molecular similarity to highlight the challenges of routine immunoassay-based drug of abuse/toxicology screening in emergency medicine. 91 (91.0%) confirmed positive for 7AC (median, range: 4.2, 0.5-316.7 ng/ml) using the ion ratio test, while only 44 of the 100 (44.0%) samples confirmed positive for CLON (median, range: 3.7, 0.5-217.2 ng/ml) using the ion ratio test. Clonazepam can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. 0 Coronavirus (COVID-19): Latest Updates | Visitation PoliciesVisitation PoliciesVisitation PoliciesVisitation PoliciesVisitation Policies | COVID-19 Testing | Vaccine InformationVaccine InformationVaccine Information. Clonazepam (CLO) is an anticonvulsant benzodiazepine approved by the Food and Drug Administration for use in the treatment of seizures. Keep the medication in a place where others cannot get to it. Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. An evaluation of the diagnostic accuracy of liwuid chromatography-tandem mass spectrometry versus immunoassay drug testing in pain patients. Class, PG 1648, 3, II Safety Data . Tell your doctor if you feel an increased urge to use more of this medicine. Principles of Forensic Toxicology. MISUSE OF CLONAZEPAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. This certified Snap-N-Spike solution is suitable for use as a starting material in calibrators and controls for numerous GC/MS or LC/MS applications in forensic analysis, clinical toxicology and urine drug testing. Test results may vary depending on your age, gender, health history, and other things. [93][94], Clonazepam is not recommended for patients with chronic schizophrenia. We comply with the HONcode standard for trustworthy health information. PMC [72] Many individuals treated on a long-term basis develop a dependence. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Please see below for a list of drugs which may cause a false positive for benzodiazepines on POCT.6,11-15 Please refer to the package insert that came with the POCT device being used or contact the manufacturer for more information regarding which drugs may cause false positive results as this information may differ among devices and manufacturers. Read and carefully follow any Instructions for Use provided with your medicine. Trends in drug use from urine drug testing of addiction treatment clients. 1988;10(1):21-6.9. Any level over 0.08 mcg/mL is considered toxic. Benzodiazepines may be detected for a longer period of time in urine compared to oral fluid and blood. [10] It is a tranquilizer of the benzodiazepine class. FOIA Clonazepam is used to treat certain seizure disorders (including absence seizures or Lennox-Gastaut syndrome) in adults and children. High dosage and long-term use increase the risk and severity of dependence and withdrawal symptoms. However, negative results do not necessarily indicate the absence of the drug in question. In some cases, as with fentanyl, drugs are included on this list because the assay is also used to detect the drug in pharmaceutical preparations. This site needs JavaScript to work properly. Possible adverse effects of use of benzodiazepines such as clonazepam during pregnancy include: miscarriage, malformation, intrauterine growth retardation, functional deficits, carcinogenesis, and mutagenesis. Methods: Millennium Laboratories performed measurements on the urinary excretion of pain patients prescribed clonazepam as the indicator test. The benzodiazepine clonazepam is a prescription drug used to treat epilepsy and anxiety. WARNING This product is not for human or veterinary use. published a procedure using LC/MS/MS for the detection of some benzodiazepines in urine, including 7-aminonitrazepam, 7-aminoclonazepam, 7-aminoflunitrazepam, alprazolam, alpha-hydroxyalprazolam, oxazepam, 3-OH-diazepam, and nordiazepam [4]. can range from 0.02 to 0.08 mcg/mL. ", "[3H]Diazepam binding in mammalian central nervous system: a pharmacological characterization", "Micromolar-affinity benzodiazepine receptors regulate voltage-sensitive calcium channels in nerve terminal preparations", "Monograph - Clonazepam -- Pharmacokinetics", "Pharmacokinetics of antiepileptic drugs", "Improved micromethod for determination of underivatized clonazepam in serum by gas chromatography", "Drug Abuse Warning Network, 2006: National Estimates of Drug-Related Emergency Department Visits", Substance Abuse and Mental Health Services Administration, "Burundanga y Clonazepan. [104], The safety profile of clonazepam during pregnancy is less clear than that of other benzodiazepines, and if benzodiazepines are indicated during pregnancy, chlordiazepoxide and diazepam may be a safer choice. These stability issues along with as-needed dosing and/or low doses may further increase the likelihood of unexpected negative results. [126] It has an elimination half-life of 1960 hours. Pain Physician. Aegis Sciences Corporation Study Shows Widespread Distribution of Xylazine Read More. Jang M, Chang H, Yang W, Choi H, Kim E, Yu BH, Oh Y, Chung H. J Pharm Biomed Anal. This test measures the amount of clonazepam in your blood. Diazepam in particular has been noted to be detected longer in the urine of obese patients.4 Period of detection studies in toxicology are often limited, and special populations of patients are often excluded. Clonazepam, like other benzodiazepines, may impair a person's ability to drive or operate machinery. 2002 Oct;26(7):471-8. doi: 10.1093/jat/26.7.471. 0000011260 00000 n A highly sensitive NCI-GC-MS method for the simultaneous quantitation of CLO and its major metabolite 7-ACLO in urine was developed and validated. [136], It is marketed under the trade name Rivotril by Roche in Argentina, Australia, Austria, Bangladesh, Belgium, Brazil, Bulgaria, Canada, Colombia, Costa Rica, Croatia, the Czech Republic, Denmark, Estonia,[137] Germany, Hungary, Iceland, Ireland, Italy, China, Mexico, the Netherlands, Norway, Portugal, Peru, Pakistan, Romania, Serbia, South Africa, South Korea, Spain, Turkey, and the United States; Emcloz, Linotril, Lonazep and Clonotril in India and other parts of Europe; under the name Riklona in Indonesia and Malaysia; and under the trade name Klonopin by Roche in the United States. Such data would be of great importance to law enforcement agencies trying to determine the best time interval for urine collection from a victim of drug-facilitated sexual assault in order to reveal drug use. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Deposition of 7-aminoclonazepam and clonazepam in hair following a single dose of Klonopin. [Benzodiazepine (clonazepam, nitrazepam, diazepam)]. 2000 Oct;24(7):614-20. doi: 10.1093/jat/24.7.614. If you use clonazepam during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks. [125] Clonazepam is metabolized extensively via nitroreduction by cytochrome P450 enzymes, including CYP3A4. Clonazepam, when used late in pregnancy, may result in the development of a severe benzodiazepine withdrawal syndrome in the neonate. Long-acting benzodiazepines such as clonazepam are not generally recommended for the elderly due to the risk of drug accumulation. Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, or coma. the opiates assay detects morphine and codeine similarly, but oxycodone is detected poorly). [10] Dependence occurs in one-third of people who take benzodiazepines for longer than four weeks. Tell your doctor about all other medicines you use. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide. 7-aminoclonazepam is superior to clonazepam for detection of clonazepam use in oral fluid by LC-MS/MS 7AC should be the analyte measured in OF for the detection of CLON use. Seal Beach, CA: Biomedical Publications; 2017.2. Confirmation Tests Benzodiazepine Confirmation, Random, Urine Approximate Detection Times [9], Clonazepam was patented in 1960 and went on sale in 1975 in the United States from Roche. Abernathy DR, Greenblatt DJ, Divoll M, Shader RI. [88], The elderly metabolize benzodiazepines more slowly than younger people and are also more sensitive to the effects of benzodiazepines, even at similar blood plasma levels. This site needs JavaScript to work properly. [113] Because clonazepam is effective in low milligram doses (0.5mg clonazepam = 10mg diazepam),[114][115] it is said to be among the class of "highly potent" benzodiazepines. The degree of tolerance is more pronounced with clonazepam than with chlordiazepoxide. It's a type of medicine called a benzodiazepine. The objective of this paper was to determine how long after administration of benzodiazepine clonazepam (CLO), its major metabolite 7-aminoclonazepam (7-ACLO) could be detected in urine collected from 10 healthy volunteers who received a single 3-mg dose of Klonopin (clonazepam). [32] Rapid eye movement sleep behavior disorder responds well to low doses of clonazepam. Drugs of Abuse: Note: This product is intended for research and manufacturing uses only. Such aberrant behavior should be considered in the context of the entire patient presentation with a provider using his or her clinical judgment to assess this possibility. [127], Clonazepam passes rapidly into the central nervous system, with levels in the brain corresponding with levels of unbound clonazepam in the blood serum. Drug monitoring of benzodiazepines is often performed in toxicology and pain management settings. Applies only to results expressed in units of measure originally reported by the performing laboratory. and transmitted securely. The use of 7AC as an analyte for the detection of both CLON compliance and undisclosed use is also recommended. Anti-epileptic drugs, benzodiazepines such as clonazepam in particular, should be reduced in dose slowly and gradually when discontinuing the drug to mitigate withdrawal effects. Negrusz A, Bowen AM, Moore CM, Dowd SM, Strong MJ, Janicak PG. 0000003560 00000 n Selling or giving away this medicine is against the law. have a problem. The stability of benzodiazepines in saliva. Clonazepam, marketed as Klonopin and Rivotril, is a long-acting benzodiazepine with anxiolytic, anticonvulsant, muscle relaxant, and hypnotic properties. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). official website and that any information you provide is encrypted [16][17], Clonazepam is prescribed for short term management of epilepsy, anxiety, and panic disorder with or without agoraphobia.[18][19][20]. Therapeutic medicine levels All urine samples (1 mL) were extracted following addition of the internal standard (D(5)-diazepam) and enzymatic hydrolysis ( beta-glucuronidase) using solid-phase extraction columns. One hundred samples were presumptive-positive for 7AC and/or CLON. [116] The anticonvulsant properties of benzodiazepines are due to the enhancement of synaptic GABA responses, and the inhibition of sustained, high-frequency repetitive firing. Lund HM, iestad El, Gjerde H, Christophersen AS. 5-(2-Chlorophenyl)-7-nitro-1,3-dihydro-1,4-benzodiazepin-2-one, O=C1CN=C(c2ccccc2Cl)c2cc([N+](=O)[O-])ccc2N1, InChI=1S/C15H10ClN3O3/c16-12-4-2-1-3-10(12)15-11-7-9(19(21)22)5-6-13(11)18-14(20)8-17-15/h1-7H,8H2,(H,18,20), "Benzodiazepine Equivalency Table" based on, Rapid eye movement sleep behavior disorder, Long-term effects of benzodiazepines Neonatal effects, "Addiction: Part I. Benzodiazepines--side effects, abuse risk and alternatives", "Benzodiazepines in epilepsy: pharmacology and pharmacokinetics", "Prescribed Benzodiazepines and Suicide Risk: A Review of the Literature", "Propofol treatment of refractory status epilepticus: a study of 31 episodes", "Clonazepam: medicine to control seizures or fits, muscle spasms and restless legs syndrome", "Clonazepam add-on therapy for drug-resistant epilepsy", "[Restless legs syndrome: diagnosis and treatment.
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