Clobazam
Class: Benzodiazepine (antiepileptic and anxiolytic)
Indications
- Adjunctive therapy for epilepsy (especially Lennox-Gastaut syndrome)
- Short-term management of anxiety disorders
- Seizure clusters or status epilepticus (as per protocol)
Mechanism of Action
- Enhances effect of GABA at GABA-A receptors
- Increases neuronal inhibition → anticonvulsant and anxiolytic effect
Dosage
- Adults: 10–20 mg orally once or twice daily; may increase to 30–60 mg/day in divided doses
- Children: 0.25–1 mg/kg/day orally in divided doses
- Adjust dose based on response and tolerance
Major Side Effects
- Drowsiness, sedation
- Ataxia, dizziness
- Behavioral changes (agitation, irritability)
- Memory impairment (rare)
- Dependence and withdrawal symptoms on abrupt discontinuation
Contraindications
- Hypersensitivity to clobazam or benzodiazepines
- Severe respiratory insufficiency
- Severe hepatic impairment
- Sleep apnea (risk of respiratory depression)
- Myasthenia gravis
Compatible Solvent / Administration
- Oral tablets, oral suspension
- Take with or without food
Special Precautions
- Monitor for sedation, cognitive impairment, and paradoxical reactions
- Do not abruptly discontinue; taper gradually to avoid withdrawal seizures
- Use caution in elderly and in combination with other CNS depressants
Key Point: Clobazam is a benzodiazepine used mainly as adjunctive therapy in epilepsy, with sedation and dependence as important considerations.