I have used low doses, from 1.5 to 4.0 mg. per day of clonazepam as a
treatment for anxiety, for about 10 years".  About three years ago I
was diagnosed with a neuroopathy in both ankles and feet which renders
me somewhat unstable laterally. My feet and ankles become very tired
after walking any appreciable distance -- e.g. a mile or more but
recover  quickly. My physician says that what I experience is
very likely a drug sideeffect since it is bilateral but will not
consider that it might edue to clonazepam. The information
sheet that comes with the drug says that it sometimes causes "gait
disturbances".  I have none of the other symptoms of peripheral
neuropathy such as burning or tingling.  I am not diabetic. My
physician says that the pulse in my ankles is strong. I am 79 years
old.  I would like to know if the medical literature indicates that
this is sometimes a side effect of long term use of clonazepam and if
so references to those articles.

Clonazepam certainly seems to be effective against panic disorder and
seizures, and also has a variety of other uses in both adult and
pediatric patients. There is a lot of information available on the
side effects of clonazepam. Unfortunately, most of it comes from sites
like http://www.prozactruth.com/clonazepam.htm. Nothing against such
sites, but unless the information is published in a paper signed by a
guy with M.D. or Ph.D. after his name, your doctor is unlikely to be
swayed.

However, that does not mean the information does not have merit. The
prozactruth.com site identifies several central nervous system side
effects beside altered behavior. Those effects include unsteady gait,
slurred speech, dysarthria, vertigo, and insomnia.

The site http://www.whatmeds.com/meds/clonazepam.html lists a litany
of side effect ranging from increased salivation to tremors to
constipation to fatigue to ataxia (the technical term for
uncoordinated muscles, which can lead to shaky movements and unsteady
gait).

While it is not hard to demonstrate that clonazepam can cause ataxia, 
none of the study abstracts I read said anything about ataxia being
related specifically to long-term use.

The site http://www.mentalhealth.com/drug/p30-r04.html lists much the
same side effects that I found on the other sites, but the Canadian
monograph contains one additional piece of data ? studies indicate
that 30% of people who take clonazepam have ataxia symptoms. Only
drowsiness (50%) occurs more often. This research was taken from the
Internet Mental Health Web site, which is copyrighted by Phillip W.
Long, M.D.

The mentalhealth.com site seems pretty legitimate, though I don?t know
whether your doctor will be impressed. However, if you?re looking for
some ammo you can take to your doctor, I have some possibilities for
you:

According to a study by Harvard researchers at Massachusetts General
Hospital, ataxia is more common in patients who take the larger doses,
3 or 4 mg. They conclude that smaller doses offer a better mix of
effectiveness and tolerability.
(http://www.biopsychiatry.com/clonazepam.html).

Another study by a Canadian doctor from the Royal Victoria Hospital in
Montreal listed ataxia, drowsiness, and behavioral changes as the
primary side effects of clonazepam. That study was published in the
Journal of Clinical Psychiatry, November 1988.


Other information:

Apparently, clonazepam is more effective at treating depression than
obsessive-compulsive disorders.
http://www.biopsychiatry.com/clonazepam-depadj.htm
http://www.biopsychiatry.com/clonazepam.htm 

Sometimes clonazepam is used to treat ataxia, as documented in a study
published in a neurology journal in May 2000.

A generic version of clonazepam was approved back in 1996, so if
you?re paying top dollar for a brand-name product, you?re paying too
much.


V

Google search strategies:

clonazepam gait side effect

excelent timely job of research.  I appriciate the professional help