Document Detail

Discontinuation of clonazepam after long-term treatment.
MedLine Citation:
PMID:  2502386     Owner:  NLM     Status:  MEDLINE    
Frequent unwanted side effects and development of tolerance are the main disadvantages of clonazepam (CZP) in long-term treatment of epileptic patients. A review of the literature shows that CZP tolerance more often appears in severe forms of childhood epilepsy (West and Lennox-Gastaut syndromes) than in other epileptic syndromes. We prospectively studied the consequences of CZP discontinuation in 40 consecutive children with difficult-to-treat epilepsies and multiple-drug therapy. The CZP was reduced stepwise in a variable daily reduction rate (0.003-0.16 mg/kg), while serum levels of the comedication were kept unchanged. In only three children (7.5%), CZP was believed to have had some antiepileptic effect; in 30 (75%) it had been ineffective, whereas in six (15%), a decrease in seizure frequency after CZP discontinuation even suggested a negative therapeutic effect. Discontinuation symptoms, mostly in the form of a transitory exacerbation of seizure frequency, occurred in 19 children (47.5%). These children had a significantly higher CZP dose and longer duration of treatment than did children without discontinuation symptoms, but there was no difference between the two groups related to the rate of CZP discontinuance.
U Specht; H E Boenigk; P Wolf
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  30     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:    1989 Jul-Aug
Date Detail:
Created Date:  1989-09-01     Completed Date:  1989-09-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  458-63     Citation Subset:  IM    
Epilepsie-Zentrum Bethel, Kinderklinik Kidron, Bielefeld, F.R.G.
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MeSH Terms
Child, Preschool
Clonazepam / administration & dosage,  adverse effects*
Drug Tolerance
Epilepsies, Myoclonic / drug therapy
Epilepsies, Partial / drug therapy
Epilepsy / drug therapy
Prospective Studies
Seizures / chemically induced*
Spasms, Infantile / drug therapy
Substance Withdrawal Syndrome*
Time Factors
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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