Current Status of the 1,4‐ and 1,5‐Benzodiazepines in the Treatment of Epilepsy: The Place of Clobazam

  title={Current Status of the 1,4‐ and 1,5‐Benzodiazepines in the Treatment of Epilepsy: The Place of Clobazam},
  author={Mary May Robertson},
  • M. Robertson
  • Published 1 April 1986
  • Medicine, Psychology
  • Epilepsia
Summary: The 1,4‐benzodiazepines have a recognised place in the treatment of epilepsy. Thus, diazepam, clonazepam, and, more recently, lorazepam are used intravenously for status epilepticus. Oral clonazepam has proved useful as adjunctive therapy in generalised absence seizures, myoclonic seizures, and partial seizures. Oral nitrazepam is well known for its use in the treatment of infantile spasms with hypsarrythmia and in the myoclonic epilepsies of childhood. Clobazam, a 1,5‐benzodiazepine… 

The place of clobazam in the treatment of epilepsy: An update

Clobazam, the only marketed 1,5‐benzodiazepine, has been shown in eight controlled studies involving 291 patients to be significantly superior to placebo, while in 35 open studies embracing 2259 patients, it has produced an overall reduction in seizure frequency, with some 18 per cent of patients being rendered seizure free.

The Use of Clobazam, Midazolam, and Nitrazepam in Epilepsy

Summary: The benzodiazepines clobazam (CLB), midazolam (MDL), and nitrazepam (NZP) all have proven efficacy in epilepsy management, but their differences in physical properties, pharmacokinetic

Clobazam: A Safe, Efficacious, and Newly Rediscovered Therapeutic for Epilepsy

Clobazam is an oral 1,5‐benzodiazepine used worldwide for the treatment of many types of epilepsies, although it is currently only approved for Lennox–Gastaut syndrome in the USA. This anticonvulsant

Clobazam: a newly approved but well-established drug for the treatment of intractable epilepsy syndromes.

Historical and recent data are reviewed to help practitioners better understand clobazam's clinical properties and usage and safety profile appears to be similar to that of other benzodiazepines, but with substantially decreased sedation and increased psychomotor performance.

Cognitive sequelae of 1,4‐ and 1,5‐benzodiazepines

A relationship was found between performance on three measures and serum level of clobazam, such that response latency decreased with increasing serum level, and for clonazepam, a significant correlation was found on one task, in the direction of increased response latency with increasing drug level.

Comprehensive overview: efficacy, tolerability, and cost-effectiveness of clobazam in Lennox–Gastaut syndrome

  • M. Faulkner
  • Medicine, Psychology
    Therapeutics and clinical risk management
  • 2015
Data from an open-label extension trial have confirmed that clobazam is efficacious for the treatment of seizures associated with LGS, particularly atonic seizures (drop seizures), over the long term.

Therapeutic drug monitoring of old and newer anti-epileptic drugs

This review shows that TDM may be helpful for a number of these newer drugs, including carbamazepine, clobazam, clonazepam, ethosuximide and zonisamide, which have undergone extensive clinical studies.

Systematic review of clobazam use in patients with status epilepticus

There is not sufficient evidence to determine the safety and efficacy of clobazam in the setting of SE, however, the current limited evidence combined with the unique characteristics of CLB suggest that the drug might be considered as an add‐on option in SE patients, with a suggested dosage range of 10–60 mg/day.



Clonazepam: A Review of its Pharmacological Properties and Therapeutic Efficacy in Epilepsy

Clonazepam is a close structural and pharmacological relative of nitrazepam, and has a broad spectrum of activity against the various types of epilepsy, and is effective in many patients whose condition has proved resistant to other antiepileptic drugs.

Clonazepam in the treatment of epilepsy. A controlled clinical trial in simple absences, bilateral massive epileptic myoclonus, and atonic seizures.

The antiepileptic effect of clonazepam was significantly superior to placebo and was estimated as remarkably good and side-effects of somnolence, fatigue, drowsiness, and coordination disturbances occurred in most of the patients, but subsided spontaneously or could be controlled by slow increase or slight reduction of dosage.

Oxazepam in the treatment of psychomotor epilepsy

  • H. Lou
  • Psychology, Medicine
  • 1968
The aim of the present study has been to examine the clinical effect of Serax in the treatment of psychomotor epilepsy and find the values were found to be 5 to 10 times higher for oxazepam than chlordiazepoxide.

The anticonvulsant activity of chlordiazepoxide and Ro 5‐2807

Reports indicate that chlordiazepoxide synchronizes the EEG and increases the fast frequencies in a manner similar to phenobarbital and meprobamate, and in most of the patients treated, this drug effectively controlled or reduced the frequency of seizures.

Clobazam: A Review of its Pharmacological Properties and Therapeutic Use in Anxiety

Clobazam seems to be initially effective against all varieties of epilepsy in about 75% of epileptic patients, but it loses all or part of its efficacy in over one-third of those who benefited from its effect.

Antiepileptic effects of Clobazam in children

Treatment of epilepsy with clonazepam and its effect on other anticonvulsants.

It is concluded that clonazepam is particularly valuable in epilepsy with associated myoclonsu and in photosensitive epilepsy.

Anticonvulsant action of clobazam and desmethylclobazam in reflex epilepsy in rodents and baboons

It is concluded that in the baboon and probably also in man the metabolite desmethylclobazam is responsible for a substantial part of the antiepileptic effect of clobzam.

Nitrazepam in myoclonic epilepsies.

Nitrazepam (Mogadon), an analogue of chlordiazepoxide hydrochloride (Librium), is more potent than other benzodiazepine derivatives against experimental seizures in animals; its anticonvulsant efficacy has been demonstrated in clinical trials.