Long-term use of clobazam in Lennox-Gastaut syndrome: experience in a single tertiary epilepsy center

Clin Neuropharmacol. Jan-Feb 2013;36(1):4-7. doi: 10.1097/WNF.0b013e3182770730.

Abstract

Objective: Clobazam (CLB) is a 1,5-benzodiazepine, which is known to be effective for treating refractory partial epilepsy. We have evaluated the long-term efficacy and tolerability of CLB as an add-on therapy in patients with Lennox-Gastaut syndrome (LGS).

Methods: Forty-six patients with LGS who had received CLB add-on therapy were enrolled in this study. We retrospectively reviewed their clinical characteristics, including type of seizures, use of CLB, efficacy, adverse events, and retention rate.

Results: The mean±SD dose of CLB was 0.70±0.37 mg/kg per day (range, 0.16-1.60 mg/kg per day). After 1 month on CLB, 15 patients (32.6%) became seizure-free and 10 patients (21.7%) had 50% or greater seizure reduction. Response to CLB was not significantly associated with age, sex, or etiology (symptomatic or not). Five (10.8%) of 46 patients maintained seizure remission for more than 12 months. Tolerance developed in 48.0% of initial responders, and the 3-year retention rate by the Kaplan-Meier method was 76.6%. Seven patients (15.2%) reported adverse events, including somnolence and behavioral change, but only one discontinued CLB.

Conclusions: Clobazam add-on therapy was effective and very tolerable in patients with LGS.

MeSH terms

  • Adolescent
  • Anticonvulsants / administration & dosage*
  • Benzodiazepines / administration & dosage*
  • Child
  • Child, Preschool
  • Clobazam
  • Epilepsy / diagnosis
  • Epilepsy / drug therapy*
  • Female
  • Humans
  • Infant
  • Intellectual Disability / diagnosis
  • Intellectual Disability / drug therapy*
  • Lennox Gastaut Syndrome
  • Male
  • Retrospective Studies
  • Spasms, Infantile / diagnosis
  • Spasms, Infantile / drug therapy*
  • Tertiary Care Centers* / trends
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Anticonvulsants
  • Benzodiazepines
  • Clobazam

Supplementary concepts

  • Epileptic encephalopathy, Lennox-Gastaut type