Seizure disorders clonazepam

Although all of the benzodiazepines are similar, certain ones are employed more for the treatment of seizure disorders. Clonazepam was the first benzodiazepine approved in the United States specihcally for the treatment of convulsive disorders. Clonazepam is a very long acting compound with potent anticonvulsant activity. Unfortunately, sedation and tolerance tend to hmit its usefulness. Drooling and hypersalivation may be troublesome in children and in infants. 

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). 

Support is scant for the efficacy of anticonvulsant agents in the treatment of OCD (Jenike 1990 Joffe and Swinson 1987). If there is a role for carbamazepine in OCD, it may be in patients with clinical or electroen-cephalographic evidence of a seizure disorder (Jenike and Brotman 1984 Khanna 1988). The anti-OC efficacy of combined SRI-carbamazepine treatment has not been adequately studied. Sodium valproate was found ineffective in two cases of OCD (McElroy and Pope 1988 McElroy et al. 1987). However, one author has suggested that sodium valproate may be a useful pretreatment for patients with OCD who might otherwise tolerate SRIs poorly (Deltito 1994). The anticonvulsant clonazepam is discussed earlier in this chapter. 

Clonazepam is commonly combined with other anticonvulsants for the treatment of seizure disorders... 

Flumazenil (used to reverse the effects of benzodiazepines) may precipitate seizures and should not be used in patients treated for seizure disorders with clonazepam... 

Clonazepam may induce grand mal seizures in patients with multiple seizure disorders... 

Clonazepam is the only benzodiazepine that is used as a solo maintenance treatment for seizure disorders... 

Clonazepam (Klonopin) Seizure disorders 20-60 7-amino-3-hydroxy... 

Phenobarbital has selective antiseizure activity at low doses and has a long half-life suitable for maintenance treatment in seizure disorders (for characteristics of barbiturates, see sedative-hypnotics). Clonazepam is usually a backup drug in absence and myoclonic seizures it causes marked sedation at anticonvulsant doses. IV lorazepam and diazepam are both used in status epilepticus. 

Clonazepam Seizure disorders, mania, movement disorders... 

Experimentally, benzodiazepines inhibit some types of seizure activity. Clonazepam, nitrazepam, and nordazepam have more selective anticonvulsant activity than most other benzodiazepines. Benzodiazepines also suppress ethanol-withdrawal seizures in human beings. However, the development of tolerance to the anticonvulsant effects has limited the usefulness of benzodiazepines in the treatment of recurrent seizure disorders (see Chapter 19). 

Clonazepam (klonopin) Oral Seizure disorders, adjunctive treatment in acute mania and certain movement disorders Tolerance develops to anticonvulsant effects 23 5 ... 

Other uses Thiopental is commonly used for the induction of anesthesia, and certain benzodiazepines (eg, diazepam, midazolam) are used as components of anesthesia protocols. Special uses include the management of seizure disorders (eg, clonazepam, phenobarbital) and muscle spasticity (diazepam). Longer-acting dmgs (eg, chlordiazepoxide, diazepam) are used in the management of withdrawal states in persons physiologically dependent on ethanol and other sedative-hypnotics. 

Lennox-Gastaut syndrome is a mixed seizure disorder combining the atypical absence seizures with tonic, tonic-clonic, or myoclonic motor patterns. The syndrome begins in childhood and usually Includes mental retardation. Although adequate control of the seizures rarely Is achieved, valproate, phenytoin, felbamate, lamotrigine, topiramate, and clonazepam have been... 

Patient 16 had presented with West syndrome at 2 yr of age, with electroencepha-lographic changes typical of this disorder. Although seizures responded to clonazepam therapy, she was tetraplegic and totally unresponsive at 3 yr of age. She had repeated episodes of bronchopneumonia. DHA therapy was begun at 3 yr. She died 3 wk later during an episode of bronchopneumonia similar to those she had suffered prior to therapy. 

Drug of choice in absence seizures Is established to be teratogenic in humans Life-threatening skin disorders may occur Visual field defects occur in up to one-third of patients Withdrawal of antiseizure drugs can cause increased seizure frequency and severity. Withdrawal is least likely to be a problem with (A) Clonazepam Diazepam Ethosuximide Phenobarbital Phenytoin... 

There is a report of seizures, unsteady gait and blurred speech in a patient with bipolar disorder and cystic fibrosis taking lithium and paroxetine both drugs were discontinued. However, this patient was abusing oxycodone and clonazepam and was also on a variety of anti-asthma medications (salbutamol, salmeterol, budesonide, montelukast and cromoglicate), so the exact cause of the seizures is unclear. ... 

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