Clonazepam, Brazil’s most consumed sedative, reached 39 million units sold in 2024, according to Anvisa, with significant use among the elderly. Indicated for acute anxiety and insomnia crises, it is often prescribed long-term, leading to silent dependency. Specialists warn of risks like memory loss and falls, particularly in those over 60, who account for about 2 million users in the country. The drug’s popularity reflects issues like loneliness and improper prescribing.
Known commercially as Rivotril, the benzodiazepine has a prolonged effect, lasting up to 24 hours. Despite being a controlled drug requiring a prescription, its low cost and availability through SUS contribute to widespread use. Anvisa data shows clonazepam outpaces other anxiolytics like alprazolam and diazepam in sales volume. Dependency, doctors say, is worsened by lack of monitoring and patients’ resistance to discontinuation.
- Side effects include confusion and cognitive impairment.
- Long-term use compromises sleep quality, missing deep sleep stages.
- Loneliness and grief are common triggers for continued use.
Popularity and risks of the drug
Clonazepam leads benzodiazepines due to its rapid efficacy and low cost, with boxes priced under R$6. However, its prolonged effect in the body, especially in the elderly with slower metabolism, heightens risks like falls and confusion.
Recurrent prescribing without medical review fuels the issue, with many patients using the drug for decades.
Health impacts on the elderly
Clonazepam dependency extends beyond physical effects, reaching emotional aspects. Patients report difficulty sleeping or relaxing without the drug, creating a cycle of continuous use.
Doctors note the drug does not address underlying issues like depression or loneliness, common in old age.
Limited access to therapies like cognitive-behavioral therapy in SUS worsens the situation, sustaining drug dependency.
History of prescribing in Brazil
High clonazepam use dates back to the 1990s, when benzodiazepines were widely prescribed as a quick fix for anxiety and insomnia.
Many elderly who began using the drug then remain dependent, with prescriptions renewed without reassessment.
Initial marketing of Rivotril cemented its name in popular culture, boosting demand.
Anvisa monitors sales, but oversight does not prevent chronic use without medical follow-up.
Alternatives to long-term use
Stopping clonazepam requires slow weaning under medical supervision to avoid rebound effects intensifying anxiety and insomnia.
Simple changes, like exercise and regular sleep schedules, can reduce reliance on the drug.
Cognitive-behavioral therapy is recommended, but its low availability in the public system limits access.
Psychological and social support is key to addressing emotional triggers for drug use.
Challenges of Brazilian aging
Rising clonazepam use reflects an aging process marked by loneliness and chronic illnesses. Many elderly turn to the drug to cope with grief, isolation, or pain, instead of receiving proper treatments like antidepressants or psychotherapy.
Solutions and prevention
Experts advocate stricter prescribing controls and investment in mental health for the elderly. Education on long-term use risks and promotion of non-drug alternatives are critical steps to reduce dependency.
