Clonazepam nervous system

Nearly all central nervous system depressants have some capacity to suppress seizures by virtue of their depressant activity on the brain and spinal cord. Clonazepam and diazepam are two benzodiazepines that depress epileptiform activity and are used in the treatment of epilepsy and seizure disorders (see Chapter 32). 

It is a benzodiazepine useful in the treatment of petitmal epilepsy, myoclonic seizures and infantile spasms. It is used in the treatment of petitmal epilepsy not responding to ethosuximide and sodium valproate. Clonazepam and diazepam act by increasing the effectiveness of the inhibitory neurotransmitter GABA, within the central nervous system. 

Most of the sedative-hypnotics are capable of inhibiting the development and spread of epileptiform activity in the central nervous system. Some selectivity exists in that some members of the group can exert anticonvulsant effects without marked central nervous system depression (although psychomotor function may be impaired). Several benzodiazepines—including clonazepam, nitrazepam, lorazepam, and diazepam—are sufficiently selective to be clinically useful in the management of seizure states (see Chapter 24 Antiseizure Drugs). Of the barbiturates, phenobarbital and metharbital (converted to phenobarbital in the body) are effective in the treatment of generalized tonic-clonic seizures. 

Postmortem findings suggested severe nervous system and respiratory depression produced by high concentrations of clonazepam and oxycodone, including collapsed lungs, aspirated mucus, and heart failure. 

Massottti, M., Schlichting, J.L., Antonacd, M.D., Giusti, P., Memo, M., Costa, E., etal. (1991) Gamma-aminobutyric acid A receptor heterogeneity in rat central nervous system studies with clonazepam and other benzodiazepine Xtgz.t As,. Journal of Experimental Pharmacology and Therapeutics, 256, 1154—1160. 

Nervous system An 85-year-old man developed delirium, hallucinations, and generalized myoclonic jerks 7 days after starting to take ciprofloxacin 500 mg bd for a hip infection [24 ]. His symptoms improved with ciprofloxacin withdrawal and oral clonazepam, but recurred on two occasions after reuse of ciprofloxacin. 

Nervous system Three infants developed movement disorders during vitamin B12 administration, with a combination of tremor and myoclonus affecting the face, tongue, and limbs in two cases the involuntary movements resolved with clonazepam and in the other with piracetam [27 ]. 

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