• See Also
  1. Seizure Disorder
  • Indications
  1. Seizure Disorder (Lennox-Gastaut Syndrome)
    1. Adjunctive anticonvulsant
  • Mechanism
  1. Benzodiazepine and partial Gamma-Aminobutyric Acid (GABA) receptor Agonist
  2. Anticonvulsant, Sedative and Anxiolytic properties
  3. Binds CNS at the Benzodiazepine-GABA-A-chloride ionophore receptor complex
    1. GABA affinity becomes increased at receptor site resulting in increased Neuron chloride channel opening
    2. Hyperpolarizes the Neuron, inhibiting the Action Potential and a decreasing Neuron excitability
  • Precautions
  1. Exercise caution in elderly
  2. Avoid in combination with Opioids and other Sedatives (e.g. other Benzodiazepines)
    1. May result in respiratory depression or coma
  1. Available as tablets, oral suspension (2.5 mg/ml) and oral films (Sympazan)
    1. Film (Sympazan) should be applied to Tongue and allowed to dissolve (do not take with liquids)
  2. Weight >30 kg (and age >=2 years)
    1. Start 5 mg orally twice daily
    2. Increase to 10 mg orally twice daily after 1 week
    3. Increase to 20 mg orally twice daily after 2 weeks
  3. Weight <30 kg (and age >=2 years)
    1. Start 5 mg orally daily
    2. Increase to 5 mg orally twice daily after 1 week
    3. Increase to 10 mg orally twice daily after 2 weeks
  • Metabolism
  1. CYP2C19 metabolism
    1. Lower dose and titrate slowly in slow CYP2C19 metabolizers
  • Safety
  1. Avoid in Pregnancy
    1. Use in second and third trimester associated with fetal adverse effects
    2. Effects include decreased fetal movement, Floppy Infant syndrome and medication dependence and withdrawal
  2. Unknown Safety in Lactation
  • Resources
  1. Clobazam (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=a77ffbdd-4e3e-4ec4-b0fa-b51ee610df0f
  • References
  1. (2022) Presc Lett, Resource #361206, Antiseizure Medications
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 56-7
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia