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Add-on Trial of Clobazam in Intractable Adult Epilepsy with Plasma Level Correlations

Published online by Cambridge University Press:  18 September 2015

A. Guberman ,
M. Couture ,
K. Blaschuk  and
A. Sherwin
A. Guberman*
Affiliation:
Division of Neurology, Montreal
M. Couture
Affiliation:
Division of Neurology, Montreal
K. Blaschuk
Affiliation:
Ottawa General Hospital, Ottawa and the Montreal Neurological Institute, Montreal
A. Sherwin
Affiliation:
Ottawa General Hospital, Ottawa and the Montreal Neurological Institute, Montreal
*
Division of Neurology, Ottawa General Hospital, 501 Smyth Road, Ottawa, Ontario, Canada K1H 8L6
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Abstract:

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Clobazam, a novel benzodiazepine, was used as an add-on agent in 47 adult patients with intractable epilepsy and a variety of seizure types. A >75% reduction in seizure frequency was observed in 42% (18) of the patients and a >50% reduction in 65% (29) of the patients which was sustained over a mean follow-up period of 13.3 (±5.6) months. Nine patients had to discontinue the drug due to minor adverse effects or increased seizures. Possible tolerance developed in 6 patients. Plasma levels of the active metabolite N-desmethylclobazam were linearly related to dosage and appeared to correlate with both therapeutic and toxic responses. Clobazam appears to be a safe and effective add-on antiepileptic for a wide variety of seizure types in intractable epilepsy.

Résumé:

RÉSUMÉ:

Le clobazam, une nouvelle benzodiazépine, a été utilisé comme traitement d'appoint chez 47 adultes présentant une épilepsie réfractaire et des crises de types variés. Une diminution de plus de 75% de la fréquence des crises a été observée chez 42% (18) des patients et une diminution de plus de 50% chez 65% (29), diminution maintenue sur une période de suivi moyenne de 13.3 (±5.6) mois. Neuf patients ont dû cesser la médication à cause d'effets secondaires mineurs ou d'une augmentation des crises. Il est possible qu'une tolérance se soit développée chez 6 patients. Les niveaux plasmatiques du métabolite actif, le N-desmethylclobazam, étaient en relation linéaire avec la dose et semblaient corréler avec la réponse thérapeutique et la toxicité. Le clobazam semble être un agent antiépileptique d'appoint sécuritaire et efficace dans une grande variété de types de convulsions dans l'épilepsie réfractaire.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 17 , Issue 3 , August 1990 , pp. 311 - 316
Copyright
Copyright © Canadian Neurological Sciences Federation 1990

References

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