Benzodiazepines for Epilepsy
Clonazepam is the most commonly used benzodiazepine for long-term treatment of epilepsy. It is available in tablet form.
Diazepam and lorazepam are given in a vein (intravenous, or IV) for the treatment of prolonged seizures or status epilepticus. Diazepam is also available in a gel form that can be injected into the rectum by a caregiver during clusters of seizures (acute repetitive seizures).
These medicines are used in infants and children but with careful dosage adjustments based on weight and age.
How It Works
Benzodiazepines are minor tranquilizers (sedatives) that prevent or stop seizures by slowing down the central nervous system. This makes abnormal electrical activity less likely.
Why It Is Used
Clonazepam may be used to treat:
IV diazepam and lorazepam are often used to treat prolonged seizures or status epilepticus. Diazepam may be used during short periods of increased, repeated, or prolonged seizures (acute repetitive seizures) in people who are taking other antiseizure drugs for long-term treatment.
How Well It Works
In general, benzodiazepines are not usually the first choice for long-term treatment of epilepsy. Although clonazepam or clorazepate may be quite helpful for a few people, most people do not respond very well to them over the long term.
But occasional use of diazepam to treat seizures can be very effective. Treatment with rectal diazepam within 15 minutes of the beginning of a prolonged seizure or a series of seizures usually ends the seizure activity.
The most common side effects of benzodiazepines include:
The U.S. Food and Drug Administration (FDA) has issued a warning on clonazepam (Klonopin) and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using this medicine. Instead, people who take clonazepam should be watched closely for warning signs of suicide. People who take clonazepam and who are worried about this side effect should talk to a doctor.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
It may take time and careful, controlled adjustments by you and your doctor to find the combination, schedule, and dosing of medicine to best manage your epilepsy. The goal is to prevent seizures while causing as few side effects as possible. After you and your doctor figure out the medicine program that works best for you, make sure to follow your program exactly as prescribed.
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