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Cited by 27Epilepsy research and treatmentPharmacological Effects and Toxicity StudiesDiet and metabolism studies

The use of clobazam, midazolam, and nitrazepam in epilepsy

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Shorvon, Simon D.·1998·Epilepsia
DOI 10.1111/j.1528-1157.1998.tb05109.x
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Abstract

Summary: The benzodiazepines clobazam (CLB), midazolam (MDL), and nitrazepam (NZP) all have proven efficacy in epilepsy management, but their differences in physical properties, pharmacokinetic characteristics, side‐effect profiles, and intrinsic antiepileptic activity lead to different indications for use. CLB is a 1,5‐benzodiazepine that causes less sedation than 1,4‐benzodiazepines but offers improved antiepileptic action. It has been extensively studied in both open and controlled trials as antiepileptic therapy for a variety of seizure types. It is now widely used in European countries as adjunctive therapy for partial and secondarily generalized seizures. Clinical trial experience, however, indicates that more than 50% of patients develop tolerance to the antiepileptic effects of CLB. Therefore, CLB has had a relatively limited role as a routine antiepileptic drug. It has further use as an intermittent or occasional therapy, in which tolerance is of less concern. MDL is a water‐soluble 1,4‐benzodiazepine. It is the only drug in this class that is useful when given by i.m. injection, although MDL can also be administered rectally or by i.v. bolus or infusion. MDL has a very short elimination half‐life and is used for emergency treatment of status epilepticus or acute seizures. NZP has reported efficacy in acute epilepsy, although it is not routinely used for this situation. Although there have been no controlled studies of NZP for chronic epilepsy treatment, this drug appears to be moderately effective in a wide range of seizure types. NZP is predominantly used in children with severe epilepsy intractable to conventional medications.

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  • Clobazam produces less sedation than other benzodiazepines.

    “and it produces less sedation than other BZDs do (140).”

    From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [140]

  • Clobazam is highly effective as adjunctive therapy for partial and generalized seizures, for intermittent therapy, and for controlling nonconvulsive status epilepticus.

    “It is highly effective as adjunctive therapy for partial and generalized seizures, for intermittent therapy and for controlling nonconvulsive status epilepticus”

    From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [140]

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Research works printed but not linked: 17

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  12. [62]62. Jan JE, Riegl JA. Nitrazep orders. Clin Res 1970;18:2 62. Jan JE, Riegl JA. Nitrazepam in the treatment of convulsive disorders. Clin Res 1970;18:220.
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Authors
Shorvon, S. D.
Affiliations
National Hospital for Neurology and Neurosurgery (GB)
Corresponding author
Shorvon, Simon D.
ORCID
Shorvon, Simon D.
Venue
Epilepsia
Publisher
Wiley
Published
1998-01
Volume
39
Issue
S1
ISSN
  • 0013-9580 (ISSN-L)
  • 1528-1167
DOI
10.1111/j.1528-1157.1998.tb05109.x
OpenAlex
W2070917660
Cited by
27
References
72
Citations by year
2024: 1 · 2023: 1 · 2019: 2 · 2018: 2 · 2013: 3 · 2012: 1
FWCI
1.30
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 3595 d)
Locations
  • Epilepsia (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
Keywords
clobazam, midazolam, nitrazepam, benzodiazepines, epilepsy, antiepileptic drugs, adjunctive therapy, focal seizures, secondary generalized seizures, status epilepticus, intractable childhood epilepsy, pharmacokinetics, sedation

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