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Your healthcare provider may also order other tests, including: 7-aminoclonazepam. Bookshelf [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. Int J Spectrosc. The pathway by which clonazepam is metabolized is usually impaired in newborns. Careers. Using LC-MS/MS, clonazepam was detected in 297 traffic cases, 92 criminal cases (perpetrators or victims of a crime) and in 140 postmortem cases. Clonazepam was approved in the United States as a generic drug in 1997 and is now manufactured and marketed by several companies. This limits the utility of the comprehensive drug screen for monitoring compliance or for confirming the results of screening immunoassays. [16][17], Clonazepam is prescribed for short term management of epilepsy, anxiety, and panic disorder with or without agoraphobia.[18][19][20]. Some withdrawal symptoms may last up to 12 months or longer. Kempf J, Wuske T, Schubert R, Weinmann W. Pre-analytical stability of selected benzodiazepines on a polymeric oral fluid sampling device. Conclusions: J Anal Toxicol. Dizziness or drowsiness can cause falls, accidents, or severe injuries. [89] Clonazepam is generally not recommended for use in elderly people for insomnia due to its high potency relative to other benzodiazepines. A tendency for re-offending in drug-facilitated crime. Application to forensic cases of drug facilitated crimes. You may have this test if it's possible you have taken an overdose of clonazepam. official website and that any information you provide is encrypted 2013 Dec 31;2013:245376. doi: 10.1155/2013/245376. Because of the intended primary use of the comprehensive drug screen, the GC/MS assay was designed for rapid detection of a wide range of drugs when present at overdose concentrations, rather than for high sensitivity for any specific drug. 2002 Oct;26(7):471-8. doi: 10.1093/jat/26.7.471. Clonazepam, sold under the brand names Klonopin and Rivotril, is a medication used to prevent and treat seizures, panic disorder, anxiety disorders, and the movement disorder known as akathisia. ", "[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. What medication is the patient prescribed? As a class of drugs, benzodiazepines are among the drugs most commonly prescribed in the western hemisphere because of their efficacy, safety, low addiction potential, minimal side effects, and high public demand for sedative and anxiolytic agents. If clonazepam is used during pregnancy or breastfeeding, it is recommended that serum levels of clonazepam are monitored and that signs of central nervous system depression and apnea are also checked for. In addition, it is frequently used to treat drug addicts and is itself a popular drug of abuse. 0000001057 00000 n Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, or coma. A Case Report of Clonazepam Dependence: Utilization of Therapeutic Drug Monitoring During Withdrawal Period. Taking other antiseizure medicines may affect your results. Application to forensic cases of drug facilitated crimes. PMC Dangerous side effects or death could occur. Trends in drug use from urine drug testing of addiction treatment clients. Version: 10.01. gabapentin, sertraline, alprazolam, fluoxetine, lamotrigine, Zoloft, Xanax, pregabalin, diazepam, Prozac. Quantitation of clonazepam and its major metabolite 7-aminoclonazepam in hair. 0000003560 00000 n [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, 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. [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. 7-Aminoclonazepam (CRM) (Item No. Test Result Name. Klonopin vs Xanax - How are they different? Epub 2012 Jul 19. 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. [106] It acts by binding to the benzodiazepine site of the GABA receptors, which enhances the electric effect of GABA binding on neurons, resulting in an increased influx of chloride ions into the neurons. 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). 7-Aminoclonazepam. [9] In addition, clonazepam decreases the utilization of 5-HT (serotonin) by neurons[111][112] and has been shown to bind tightly to central-type benzodiazepine receptors. World Psychiatry. Aegis Sciences Corporation Study Shows Widespread Distribution of Xylazine Read More. government site. Please enable it to take advantage of the complete set of features! Click on the title Specimen Validity Testing and Specimen Tampering to download a copy of this chapter. xref It may also be used to treat panic attacks, insomnia, and generalized anxiety. In OF the levels of 7AC were approximately 2.4-fold higher than CLON. The characterization of human urine for specimen validity determination in workplace drug testing: a review. These stability issues along with as-needed dosing and/or low doses may further increase the likelihood of unexpected negative results. Please note that the interpretation of benzodiazepine results differs when using presumptive vs. definitive testing methods, and may differ among laboratories. 14263 | ISO60181). 0000006281 00000 n Standard curves for CLO (500-4000 pg x mL(-1)) and 7-ACLO (50-2000 pg x mL(-1)) were prepared by spiking aliquots of negative urine. J Anal Toxicol. Stability of pain-related medications, metabolites, and illicit substances in urine. 0000004622 00000 n 0 . [117], Benzodiazepines, including clonazepam, bind to mouse glial cell membranes with high affinity. LP28541-8 7-Aminoclonazepam 7-Aminoclonazepam is a metabolite of clonazepam, a benzdiazepine drug used to treat or control seizures, panic attacks, and akathisia. startxref 237 0 obj <>stream Brand names: KlonoPIN, KlonoPIN Wafer At Aegis, we understand your concerns as you evaluate definitive drug testing results. Using clonazepam with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. [80] Many studies have found that tolerance develops to the anticonvulsant properties of clonazepam with chronic use, which limits its long-term effectiveness as an anticonvulsant. Pain Physician. 0000011260 00000 n Mikel C, West R, Crews B, et al. [citation needed] Clonazepam is also effective in the management of acute mania. [8], Common side effects include sleepiness, poor coordination, and agitation. government site. As a result, drugs present at therapeutic concentrations may not always be detected. Clonazepam is also used to treat panic disorder (including agoraphobia) in adults. [95], Clonazepam has similar effectiveness to other benzodiazepines at often a lower dose. Read and carefully follow any Instructions for Use provided with your medicine. Careers. Benzodiazepines do not replace GABA, but instead enhance the effect of GABA at the GABAA receptor by increasing the opening frequency of chloride ion channels, which leads to an increase in GABA's inhibitory effects and resultant central nervous system depression. Clonazepam may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. This is a substance your body makes from clonazepam. Clin Infect Dis. Positive findings by GC/MS are highly reliable, due to the high specificity of mass spectrometry. The use of clonazepam during pregnancy should only occur if the clinical benefits are believed to outweigh the clinical risks to the fetus. J Chromatogr B Analyt Technol Biomed Life Sci. The benzodiazepine clonazepam is a prescription drug used to treat epilepsy and anxiety. 0000000016 00000 n 0000007155 00000 n Azole antifungals, such as ketoconazole, may inhibit the metabolism of clonazepam. NCI CPTC Antibody Characterization Program. treatment. Disclaimer. Hospitalization/Emergency Department Visit: Patients who arrive at the emergency room with a suspected poisoning or overdose may be given benzodiazepines depending on their presenting symptoms and the source of the toxicity. [23], It is also approved for treatment of typical and atypical absences (seizures), infantile myoclonic, myoclonic, and akinetic seizures. medicines that don't need a prescription and any illegal drugs you may use. 2016 Mar;95(9):e2881. Clonazepam doses are based on weight in children. -7-Aminoclonazepam (metabolite of clonazepam)-Diazepam (separate prescribable drug and . Withdrawal seizures and psychosis can occur in severe cases of withdrawal, and anxiety and insomnia can occur in less severe cases of withdrawal. 7-aminoclonazepam is superior to clonazepam for detection of clonazepam use in oral fluid by LC-MS/MS Take clonazepam exactly as prescribed by your doctor. 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). These include valproate [107][108], Benzodiazepines do not have any effect on the levels of GABA in the brain. The data are also inconclusive on whether benzodiazepines such as clonazepam cause developmental deficits or decreases in IQ in the developing fetus when taken by the mother during pregnancy. HHS Vulnerability Disclosure, Help Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. 2009;31(6):746-8.19. 20225) is a certified reference material categorized as a benzodiazepine. Both the parent drug and 7-aminoclonazepam are unstable in biofluids, and therefore specimens should be preserved with sodium fluoride, stored at the lowest possible temperature and analyzed quickly to minimize losses. 11th ed. 2009;48(12):1787-9.16. 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. xb```b`` " ,@QU@CM^R2x_c Swallow several times as the tablet dissolves. [89][91], Doses higher than 0.51mg per day are associated with significant sedation. [110], Clonazepam's primary mechanism of action is the modulation of GABA function in the brain, by the benzodiazepine receptor, located on GABAA receptors, which, in turn, leads to enhanced GABAergic inhibition of neuronal firing. 2013 Feb 23;74:213-22. doi: 10.1016/j.jpba.2012.11.002. Do not start or stop seizure medication during pregnancy without your doctor's advice. MISUSE OF CLONAZEPAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. In most cases, other drugs were also present. The urine from every subject was still positive for 7-ACLO 14 days after administration of the drug. It is extensively metabolised into pharmacologically inactive metabolites, with only 2% of the unchanged drug excreted in the urine. Background: In general, the following guidance may be helpful: Positive for alprazolam and alpha-OH-alprazolam, Write in Other field(Paper Requisition). 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. official website and that any information you provide is encrypted A breakdown of the 1,358 total drug and metabolite confirmations demonstrated 128 different drugs, which consisted of 34 NPS, 16 TID, 70 prescription and OTC drugs, 3 DSS, and 5 P/A/I (Fig. [124][8], Clonazepam is lipid-soluble, rapidly crosses the bloodbrain barrier, and penetrates the placenta. Dosage forms: oral tablet (0.5 mg; 1 mg; 2 mg), oral tablet, disintegrating (0.125 mg; 0.25 mg; 0.5 mg; 1 mg; 2 mg) bruising, or feeling dizzy. Epub 2006 Jun 30. You should not take clonazepam if you allergic to it or if you have: a history of allergic reaction to any benzodiazepine (including alprazolam, diazepam, lorazepam, Valium, Xanax, Versed, and others). It can cause side effects such as . Please enable it to take advantage of the complete set of features! Would you like email updates of new search results? scribed class of drugs in the USA. The challenges of LC-MS/MS analysis of opiates and opioids in urine. FOIA In addition, BZ are highly protein bound, reducing the free fraction of . The concentrations were thus similar among the groups, although the median value was highest in the postmortem group. Illicit Exposure: Sources of illicit exposure may include use of another persons prescription drug, acquisition of counterfeit or other illicit drugs unknowingly laced with benzodiazepines, or exposure to illicitly manufactured benzodiazepines which may share metabolites with FDA-approved benzodiazepines.3. Curr Drug Metab. 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. 1983;23:369-765. 2015 Aug;37(4):451-60. doi: 10.1097/FTD.0000000000000174. It is thought that benzodiazepines work by enhancing the activity of certain neurotransmitters in the brain. Forensic Sci Int. and transmitted securely. suicidal thoughts, and drowsiness. Bethesda, MD 20894, Web Policies Epub 2012 Nov 10. sharing sensitive information, make sure youre on a federal Results are given in micrograms per milliliter (mcg/mL). If there is a particular scenario involving unexpected results, the Aegis Clinical Team is happy to review available literature to examine possible causes of such results. Drug class: benzodiazepine anticonvulsants. Clonazepam is a medicine used to treat seizures. You may also have this test if you are having side effects from clonazepam. sharing sensitive information, make sure youre on a federal Sadrabadi EA, Khosravi F, Benvidi A, Shiralizadeh Dezfuli A, Khashayar P, Khashayar P, Azimzadeh M. Biosensors (Basel). Use all medications as directed by your doctor. In the case of improper storage, drug degradation contributing to unexpected negative results may be possible. 3494-2. Benzodiazepine metabolism: an analytical perspective. When the needle pricks your arm, you may feel a slight Clonazepam has been found effective in treating epilepsy in children, and the inhibition of seizure activity seemed to be achieved at low plasma levels of clonazepam. In addition, it is frequently used to treat drug addicts and is itself a popular drug of abuse. [10] It possesses anxiolytic, anticonvulsant, sedative, hypnotic, and skeletal muscle relaxant properties. 2016 May;40(4):310-2. doi: 10.1093/jat/bkw020. Clonazepam, marketed as Klonopin and Rivotril, is a long-acting benzodiazepine with anxiolytic, anticonvulsant, muscle relaxant, and hypnotic properties. Keep the medication in a place where others cannot get to it. 7-Aminoflunitrazepam. [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. The https:// ensures that you are connecting to the Version 2.73 58365-87-Aminoclonazepam [Presence] 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. Drugs of Abuse: Note: This product is intended for research and manufacturing uses only. Forensic Sci Int. doi: 10.1016/j.forsciint.2012.06.018. Ther Drug Monit. Kirsh KL, Heit HA, Huskey A, 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. One volunteer had the highest concentration of 7-ACLO at 3 days, two volunteers at 5 days, and one at 8 days. confusion, paranoia, nightmares, hallucinations; Drowsiness or dizziness may last longer in older adults. Read the medication guide or patient instructions provided with each medication. Any questions about how to list medications as prescribed on an Aegis laboratory requisition may be directed to the Aegis Client Services department at 1-800-533-7052. Results: The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. 7-Aminoclonazepam; Addiction management; Clonazepam; Compliance; Oral fluid. Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself. Your doctor may occasionally change your dose. These medications share common metabolites, and distinguishing which compound was ingested may be impossible.1,2 Note the analytes in red boxes below that are both metabolites and drugs available as a prescription. [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. Therefore many addiction clinics perform oral fluid (OF) testing, which unlike urine is not subject to adulteration, to monitor CLON compliance. [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. Federal government websites often end in .gov or .mil. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. The .gov means its official. These Both clonazepam and 7-aminoclonazepam break down easily. [121] Benzodiazepines inhibit cold-induced thyroid-stimulating hormone (also known as TSH or thyrotropin) release. Detection of Nitrobenzodiazepines and Their 7-Amino Metabolites in Oral Fluid. 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. Detection Times of Diazepam, Clonazepam, and Alprazolam in Oral Fluid Collected From Patients Admitted to Detoxification, After High and Repeated Drug Intake. PUGVIEW FETCH ERROR: 503 National Center for Biotechnology Information 8600 Rockville Pike, Bethesda, MD, 20894 USA Contact Policies FOIA HHS Vulnerability Disclosure National Library of Medicine National Institutes of Health The test requires a blood sample, which is drawn through a needle from a vein in your Call your doctor if this medicine seems to stop working as well in treating your seizures or panic attacks. 2013 Jan-Feb;37(1):25-9. doi: 10.1093/jat/bks080. The screening immunoassays cutoffs given are the concentrations above which the assay is reported as positive; note that a drug present below the cutoff will be reported as negative on an immunoassay screen even though it is present. 0000008997 00000 n HHS Vulnerability Disclosure, Help Keep the medication in a place where others cannot get to it. [96], Clonazepam decreases the levels of carbamazepine,[97][98] and, likewise, clonazepam's level is reduced by carbamazepine. A positive . Drugs of abuse in oral fluid collected by two different sample kitsstability testing and validation sing ultra performance tandem mass spectrometry. Mayo Clin Proc.2008;83(1):66-76.7. Coloring the toilet water blue prior to sample collection and assessing the urine temperature within 4 minutes of collection (should be between 90F and 100F) are additional measures to check for sample tampering.5-6. Clonazepam can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other drugs that can slow your breathing. Long-acting benzodiazepines such as clonazepam are not generally recommended for the elderly due to the risk of drug accumulation. 0000008084 00000 n 0000001552 00000 n Federal government websites often end in .gov or .mil. A review of the literature on sleep related disorders and abnormal sexual behaviors and experiences", "FDA expands Boxed Warning to improve safe use of benzodiazepine drug", "Get Some Sleep: Beware the sleeping pill hangover", "Recent advances in drug therapy for epilepsy", "The effects of neuroleptics on the GABA-induced Cl- current in rat dorsal root ganglion neurons: differences between some neuroleptics", "Interictal acute psychoses in temporal lobe epilepsy during withdrawal of anticonvulsant therapy", "Clonazepam, Prescription Marketed Drugs", "Sleep and aging: 2. 2000;24:579-88.6. The site is secure. and transmitted securely. Other drugs were present in all cases, with clonazepam judged to be the primary cause of death in five cases. Do not drink alcohol. PMC Clin Chim Acta. We investigated the effects of ACZP on the GABA(A) receptor-mediated currents (I(GABA)) in neurons from the nucleus reticularis thalami (NRT) of the . Tell your doctor if you are pregnant or plan to become pregnant. In blood, especially, the period of detection is generally limited to very recent use. sharing sensitive information, make sure youre on a federal 0000009460 00000 n 2007 Mar 2;166(2-3):209-17. doi: 10.1016/j.forsciint.2006.05.040. Eur J Drug Metab Pharmacokinet. 0000010374 00000 n Prolonged excretion of 7-aminoclonazepam in urine after repeated ingestion of clonazepam: a case report. Considerations for Interpreting Unexpected Results. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 8600 Rockville Pike Store at room temperature away from moisture, heat, and light. [93][94], Clonazepam is not recommended for patients with chronic schizophrenia. [125], It is effective for 68 hours in children, and 612 in adults. CLO was not detected in any of the samples. Intentional dilution may occur either with intentional ingestion of copious amounts of water or by adding water to the urine sample from the restroom sink or toilet. National Library of Medicine [130][125] Clonazepam passes through the bloodbrain barrier easily, with blood and brain levels corresponding equally with each other. Benzodiazepines (BZ) are one class of drugs that can be challenging to detect using OF [7], [9], [10]. Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Vindenes V, Strand DH, Kokster P, Gjerde H. J Anal Toxicol. The central nervous system depressing effects of the drug can be intensified by alcohol consumption, and therefore alcohol should be avoided while taking this medication. Copyright 2023 Aegis Sciences Corporation, https://www.aegislabs.com/resources/clinical-reference-guide/, Parent drug may not be present in all results; only one marker is required for a positive result, If parent drug is present in urine with no alpha-OH-alprazolam present, please consult the Aegis Clinical Team as multiple clinical factors may be pertinent to result interpretation, and this does not always indicate aberrant patient behavior, Nordiazepam, Temazepam, and/or Oxazepam may be present, Only one marker is required for a positive result, Presence of other benzodiazepine markers may indicate ingestion of other benzodiazepines, Only Temazepam and/or Oxazepam should be present. 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. Stay alert to changes in your mood or symptoms. 1988;10(1):21-6.9. Clonazepam. Urine samples with such a low creatinine level are less concentrated, and urine drug concentrations may fall below the reporting threshold in such samples. Possible adverse effects of use of benzodiazepines such as clonazepam during pregnancy include: miscarriage, malformation, intrauterine growth retardation, functional deficits, carcinogenesis, and mutagenesis. 0000001237 00000 n Abuse may lead to limited physical or psychological dependence. Would you like email updates of new search results? Use in very young children may be especially hazardous. Accessibility m@6lm -"`uX. Your results The site is secure. government site. Continue reading. Avoid driving or hazardous activity until you know how clonazepam will affect you. 2021 Mar;46(2):205-223. doi: 10.1007/s13318-020-00661-1. Negrusz A, Bowen AM, Moore CM, Dowd SM, Strong MJ, Janicak PG. [10] Deposition of 7-aminoclonazepam and clonazepam in hair following a single dose of Klonopin. 2009;186:81-510. This benzodiazepine was chosen because it forms one major metabolite, 7-aminoclonazepam which is specific for that drug. 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. Clonazepam's mode of action is to decrease abnormal electrical energy in the brain. Gonzales E, Ng G, Pesce A, et al. The immunoassay sensitivities are listed for specific drugs, but each assay can detect related compounds with similar but variable sensitivities (i.e. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.