In children, drowsiness or hyperactivity can occur if clonazepam is started too quickly. Some children are very sensitive to these side effects, which can occur even if the clonazepam is introduced at very low doses. Children up to 10 years of age or up to 30 kilograms (about 65 pounds) of body weight generally start by taking no more than 0.01 to 0.02 mg per kg each day (a total of 0.25 to 0.75 mg per day for a child weighing 65 pounds or more). This amount is given in two or three doses per day.

Dosage should then increase by no more than 0.01 to 0.02 mg/kg every third day. The final daily maintenance dose is usually 0.1 to 0.2 mg/kg of body weight (depending on total weight and age).

If high doses are prescribed for children, especially those with developmental disabilities, problems with thinking and behavior may be the result. If the dose has been increased gradually over many months or years, it can be hard to separate the effects of the clonazepam (or other benzodiazepines) from the effects of other medications, seizures, and other neurological and psychological disorders.

Reviewed March 2005 by Steven C. Schachter, MD, epilepsy.com Editorial Board.