Clobazam side effects

Benzodiazepines are the drugs of choice for status epilepticus (see above) however, development of tolerance renders them less suitable for long-term therapy. Clonazepam is used for myoclonic and atonic seizures. Clobazam, a 1,5-benzodiazepine exhibiting an increased anticonvulsant/seda-tive activity ratio, has a similar range of clinical uses. Personality changes and paradoxical excitement are potential side effects. 

Side effects. Because clobazam has been widely used as an anxiolytic, its side effects are well known and essentially similar to those of the other benzodiazepines. Thus sedation, dizziness, ataxia, blurred vision and diplopia are the most commonly reported in epileptic patients. One of the most problematic features of clobazam is its tendency to produce tolerance, an effect which may occur more frequently with clobazam than with the other widely used benzodiazepine, clonazepam. It has been estimated that at least 50% of patients develop tolerance. Tolerance to the sedative effects of the drug develop more rapidly than those to the antiepileptic effect. Clobazam should be considered as adjunctive therapy whenever treatment with a single first-line drug has proven to be ineffective. 

Parmeggiani A, Posar A, Sangiorgi S, Giovanardi-Rossi P. Unusual side-effects due to clobazam a case report with genetic study of CYP2C19. Brain Dev 2004 26 63-6. 

Clobazam and Nitrazepam. Two new investigational benzodiazepines appear to be safe and effective as anticonvulsants. However, these agents have long elimination half-lives that increase the potential not only for drug accumulation but also for residual side effects. 

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