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Diazepam versus clobazam for intermittent prophylaxis of febrile seizures
Nahid Khosroshahi1, Fatemeh Faramarzi, Payman Salamati
1Division of neurology, Department of pediatrics, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nahidkhosroshahi@yahoo.com
Insights
Intermittent clobazam is as effective as diazepam for preventing febrile seizure recurrence but causes fewer side effects like drowsiness. This finding suggests clobazam may be a preferred option for managing febrile seizures in children.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Febrile seizures are common in young children.
- Preventing seizure recurrence is crucial to minimize potential neurological impact.
Purpose of the Study:
- To compare the efficacy of intermittent clobazam versus diazepam in preventing febrile seizure recurrence.
- To assess and compare the adverse effects of clobazam and diazepam therapies.
Main Methods:
- A prospective randomized controlled trial involving neurologically normal children aged 6 months to 5 years with a history of simple febrile seizures.
- Patients received either oral clobazam (37 cases) or diazepam (35 cases) during febrile episodes, with medication use advised for the first 48 hours of fever.
- Monitoring for seizure recurrence and drug adverse effects was conducted over a 12-month follow-up period.
Main Results:
- Seizure recurrence occurred in 1.7% of the clobazam group and 3.1% of the diazepam group (P=0.474).
- Drowsiness and sedation were significantly more frequent in the diazepam group (54%) compared to the clobazam group (14.2%) (P=0.0001).
Conclusions:
- Intermittent clobazam therapy demonstrates comparable efficacy to diazepam in preventing febrile seizure recurrence.
- Clobazam is associated with significantly lower rates of adverse effects, particularly drowsiness and sedation, making it a potentially more favorable treatment option.
Objective:
To compare the effectiveness of intermittent clobazam versus diazepam therapy in preventing the recurrence of febrile seizures and assess adverse effects of each drug.
Methods:
This prospective randomized controlled trial was performed on neurologically normal children aged from 6 months to 5 years with a history of simple febrile seizures and normal electroencephalogram without any evidence of acute central nervous system infection. The patients were randomly prescribed with oral clobazam (37 cases) or diazepam (35 cases) when they developed a febrile disease. They were advised to use the medications during the first 48 h of the onset of fever. All the patients were monitored regarding developing seizure and adverse effects of the drugs. All patients were followed for 12 months.
Results:
Overall, 243 episodes of fever occurred during the period, including 116 episodes in the clobazam group and 127 episodes in the diazepam group. Recurrence of seizures occurred in 2 (1.7%) subjects in the clobazam group, and in 4(3.1%) cases in the diazepam group. (P value=0.474). Twenty cases (54%) in the diazepam group and 5 (14.2%) cases in the clobazam group developed drowsiness and sedation during the follow-up period (P value=0.0001).
Conclusions:
Intermittent clobazam therapy seems advantageous to diazepam due to similar efficacy but significantly lower adverse effects such as drowsiness and sedation.
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