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Clonazepam and diving ok?

Discussion in 'Diving Medicine' started by EANx, Apr 22, 2011.

  1. EANx

    EANx Instructor, Scuba

    My doctor prescribed Rivotril, which contains the active ingredient Clonazepam, and I have now been taking it for about three weeks. Now I am planning to go diving within the next week or so and even though my doctor said I can do anything I like (except fly airplanes) I want to be a little bit careful before I hit the depths. Clonazepam has a long half-life according to my Google results, so I wonder if anyone has any experience with this and knows if this medication taken in small doses is safe for diving?

    It is marketed by Roche under the trade-names Klonopin in the United States, and Ravotril in Chile. Other names like Rivotril or Rivatril are known throughout the large majority of the rest of the world.
  2. Duke Dive Medicine

    Duke Dive Medicine ScubaBoard Supporter Staff Member ScubaBoard Supporter

    That depends on what you're taking the clonazepam for, and whether you're taking it regularly or only as needed. You sound like you've done your research, so at the risk of reiteration: clonazepam is a benzodiazepine, in the same class as Valium (diazepam), Ativan (lorazepam), and Versed (midazolam). It is a strong central nervous system depressant.

    CNS depressants can act synergistically with nitrogen narcosis and their effects may be enhanced by pressure. Active use of any CNS depressant is a contraindication to diving, especially if it's newly prescribed and you don't know how it's going to affect you. If you're only using the medication on an as-needed basis, avoid taking it before diving. As you noted, clonazepam has a 20-50 hour half-life, so you'll have to stop taking it at least a couple of days before you plan to dive, which may conflict with your health care provider's orders and/or your need for the medication.

    Beyond the medication itself, it's also important to consider the reason you're taking it. Clonazepam has a number of indications. Hopefully you're not taking it for a seizure disorder; if so, the conversation about diving is moot. It's also prescribed for anxiety and panic disorder. This is more DocVikingo's purview, but as a general recommendation, you'll need to do an honest assessment of your mental state and decide whether you can safely perform the dives you're planning to do and effectively handle any emergency that may come up. Clonazepam is also used for other problems (neuralgia, restless leg syndrome), in which case you'll need to weigh your need for the medication vs. your desire to dive. In any event, once again, do not dive while you're actively taking the clonazepam or while it's still in your system.

    Best regards,
  3. TSandM

    TSandM Missed and loved by many. Rest in Peace ScubaBoard Supporter

    What DDM said, with the addition that central nervous system depressants are going to act additively with nitrogen narcosis to reduce awareness and impair judgment, so even if you do decide to dive on the medication (which is probably not wise) doing deep dives would be even more contraindicated.

    I agree that the reason for the drug may be the biggest issue, though. Panic kills divers.

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