Long-term use of clobazam in the management of intractable epilepsy : a prospective study

Clobazam, a 1-5 benzodiazepine, was used as add-on in the management of intractable epilepsy prospectively from 1993-1996. Forty patients who satisfied the defined inclusion and exclusion criteria with minimum one year follow-up were included. Therewere 25 male and 15 female patients, which included 15 children (37.5 ) and 25 adults (62.5 ). They had epilepsy for a mean period of 145.3 ? 106.9 months. Majority had uncontrolled complex partial seizures with or without secondary generalization. 55had single type of epilepsy and 45 had multiple type of seizures. Clobazam (Frisium) was added as an adjuvant in the dose of 5-30 mg. Patients were followed regularly to evaluate its efficacy and toxic effects. Follow up ranged from 12-66 months with amean of 27.2 ? 13 months. Twelve patients (30) were totally free from seizure, 16 (40) had more than 75 reduction in frequency and 6 (15) had no effect. Tolerance was seen in 7 ( 17.5) patients. This could be managed by increasing the dosage in a step-wise manner. Three female patients complained of increase in weight which has not been reported in the literature so far. We could reduce the dose of other antiepileptics in all and stopped one AED in 8 patients. Clobazam is recently introduced in the Indian market and relatively very economical compared to other newer antiepileptic drugs and effective as first line add-on drug in the management of refractory epilepsy in both adults and children.