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Review
. 2015 Jul;21(7):543-8.
doi: 10.1111/cns.12399. Epub 2015 Apr 28.

Clobazam: A Safe, Efficacious, and Newly Rediscovered Therapeutic for Epilepsy

Angela C Gauthier  1 , Richard H Mattson  2
Affiliations
Review

Clobazam: A Safe, Efficacious, and Newly Rediscovered Therapeutic for Epilepsy

Angela C Gauthier et al. CNS Neurosci Ther. 2015 Jul.

Abstract

Clobazam is an oral 1,5-benzodiazepine used worldwide for the treatment of many types of epilepsies, although it is currently only approved for Lennox-Gastaut syndrome in the USA. This anticonvulsant and anxiolytic therapeutic has repeatedly demonstrated great efficacy and a high safety profile in refractory epilepsy as well as in a few monotherapy trials in both children and adults. Clobazam allosterically activates the GABAA receptor, and it binds less to subunits that mediate sedative effects than other benzodiazepines. It acts quickly, maintaining a therapeutic effect for a long duration due to its active metabolite, N-desmethylclobazam. Dosage is between 5 mg and 40 mg a day, depending on patient weight, efficacy, and tolerability. Efficacy tolerance has not been a problem in the best studies. Clobazam has provided many benefits to epileptic patients. It should be used by clinicians early as an adjuvant therapy in the treatment of refractory epilepsy and even considered as monotherapy in a broad spectrum of epilepsy syndromes.

Keywords: Anticonvulsants; Benzodiazepines; Clobazam; Epilepsy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Structure of clobazam and clonazepam. Clobazam, a 1,5‐benzodiazepine, is shown here in comparison to clonazepam, a 1,4‐benzodiazepine.
Figure 2
Figure 2
Clobazam and other benzodiazepine binding sites on the GABAA receptor. Clobazam binds between the α2 and γ2 subunits on the GABAA receptor, while other benzodiazepines bind between the α1 and γ2 subunits. This selectivity allows clobazam to mediate less sedative effects than other benzodiazepines.
See this image and copyright information in PMC

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