EFFECT OF CLONAZEPAM (Ro 5-4023) ON EPILEPTIC SEIZURES

The effect of clonazepam (Ro 5-4023) was studied in 20 patients whose seizures were not satisfactorily controlled by conventional anti-epileptic treatment. The initial effect, i. e. the reduction in the number of seizures observed during the first month, was significant in 18 of the 20 patients. Relief from seizures was obtained in 9 patients. In most patients, seizures recurred in a milder form after 1–3 months of treatment. In some cases, however, a further increase in the dosage controlled the condition. The long-term improvement was marked improvement (75 per cent reduction in seizure frequency) in 8, moderate (50 per cent) in 3, while no effect was noted in 4 patients. There was no definite relation between the effect of clonazepam upon seizures and the type of drug used for previous medication. The dosage of clonazepam varied from 2–10 mg. In order to obtain relief from seizures, the use of clonazepam doses near the limits of tolerance seemed unavoidable, especially in severe focal epilepsies. The most common side effects observed were drowsiness and lethargy. No dangerous side effects were noted. Combinations of clonazepam and primidone or phenobarbital were prone to produce drowsiness, even in small doses of the benzodiazepine compound, while clonazepam in combination with hydantoines or carbamazepine was better tolerated.