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Does Clonazepam increase the risk of QT prolongation?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have been suffering from panic attacks and anxiety for several years, and on top of that, essential tremor affects my everyday life. A couple of weeks ago, my doctor prescribed Clonazepam for me, but after doing some research online, I have a few concerns. Does Clonazepam increase the risk of QT prolongation or other serious heart problems? I am particularly cautious because I have been experiencing PVCs (premature ventricular contractions) daily for over a year.

Occasionally, I also experience bradycardia and, every now and then, short bursts of an accelerated heartbeat accompanied by a fluttering sensation. These symptoms are still under investigation. I have had several ECGs, and on one of them, my QT and QTc were recorded as 412 ms and 447 ms, respectively, at a heart rate of 71 bpm. I am concerned about the possibility of Clonazepam making my QT interval longer.

I have also used Oxazepam in the past. Is it a safer option regarding the risk of QT prolongation, or can I safely continue taking Clonazepam?

Please advise.

Answered by Dr. Vivek S Narayan Pillai

Education:

DM

Professional Bio:

Dr. Vivek S. Narayan Pillai is a skilled Cardiologist with expertise in diagnosing and treating heart conditions such as hypertension, coronary artery disease, arrhythmias, and heart failure. He is proficient in advanced cardiac diagnostics, including ECG, echocardiography, and stress testing. Known for his patient-centered approach, Dr. Pillai is dedicated to providing evidence-based cardiac care to improve heart health and overall well-being.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

Long-term use of Clonazepam, as well as high doses, can increase the risk of developing acquired long QT syndrome. That said, a QTc of 447 ms is within the acceptable limit for women, which is less than 460 ms. Oxazepam is considered a safer option, but if you combine either medication with another QT-prolonging drug, the QT interval may become dangerously prolonged. Additionally, it is important to avoid low potassium levels and the use of diuretics (medications that promote urination), as these can further increase the risk.

Your description of PVCs (premature ventricular contractions) suggests that a Holter monitor and ECG might be helpful to rule out any pause-dependent arrhythmias. An echocardiogram is also recommended to rule out structural heart disease.

I hope this helps you.

Thank you.

Medically reviewed by Dr. Vinodhini J.
Published At February 8, 2020
Reviewed At November 29, 2024

Education:

DM

Professional Bio:

Dr. Vivek S. Narayan Pillai is a skilled Cardiologist with expertise in diagnosing and treating heart conditions such as hypertension, coronary artery disease, arrhythmias, and heart failure. He is proficient in advanced cardiac diagnostics, including ECG, echocardiography, and stress testing. Known for his patient-centered approach, Dr. Pillai is dedicated to providing evidence-based cardiac care to improve heart health and overall well-being.

This doctor is not available for online consultations on the platform anymore.

Education:

BDS

Professional Bio:

Dr. Vinodhini J. is a Dental Surgeon with extensive years of clinical experience. She specializes in the diagnosis, prevention, and treatment of dental and oral health issues, including restorative, surgical, and cosmetic procedures. With a patient-centered approach, she focuses on maintaining oral health, alleviating discomfort, and enhancing smiles. Her expertise ensures comprehensive care tailored to each patient’s dental needs and overall wellbeing.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

DM

Professional Bio:

Dr. Vivek S. Narayan Pillai is a skilled Cardiologist with expertise in diagnosing and treating heart conditions such as hypertension, coronary artery disease, arrhythmias, and heart failure. He is proficient in advanced cardiac diagnostics, including ECG, echocardiography, and stress testing. Known for his patient-centered approach, Dr. Pillai is dedicated to providing evidence-based cardiac care to improve heart health and overall well-being.

This doctor is not available for online consultations on the platform anymore.

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