title: Antiepileptic effect and serum levels of clorazepate on children with refractory seizures.
abstract: Clorazepate dipotassium is rapidly decarboxylated to yield desmethyl diazepam. The antiepileptic effect of clorazepate was studied in 29 epileptic children with refractory seizures. Their ages were ranged from one year 9 months to 20 years (mean 11 years 6 months). Serum clorazepate levels were also determined in 16 patients. The mean initial dose was 0.91 mg/kg/day, and the dose was increased up to 3 mg/kg/day. Within several days after initiation of clorazepate therapy, a decrease in seizure frequency was seen in patients in whom clorazepate was effective. Excellent results (decrease in seizure frequency by more than 80%) were obtained in 7 patients (24.1%), a moderate improvement with a 50 to 80% decrease was seen in 7 patients (24.1%), and a partial improvement with less than 50% decrease was seen in 7 patients (24.1%). No benefit was seen in 8 patients (27.7%). Serum clorazepate levels in patients with excellent results were 31 to 77 ng/ml (mean 55 ng/ml), those in patients with a moderate improvement were 130 to 225 ng/ml (mean 163 ng/ml), and those in patients with a partial improvement were 142 to 518 ng/ml (mean 273 ng/ml). Serum clorazepate levels in patients with no benefit were 34 to 97 ng/ml (mean 56 ng/ml). There was no direct relationship between serum clorazepate levels and clinical response. The results of this study indicate the efficacy of clorazepate for epileptic children with refractory seizures.
mesh_terms: D000293:Adolescent; D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003009:Clorazepate Dipotassium / Q000097:blood / Q000627:therapeutic use*; D003975:Diazepam / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004831:Epilepsies, Myoclonic / Q000188:drug therapy; D004828:Epilepsies, Partial / Q000188:drug therapy; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D004832:Epilepsy, Absence / Q000188:drug therapy; D006801:Humans; D007223:Infant; D003708:Nordazepam / Q000097:blood; D013036:Spasms, Infantile / Q000188:drug therapy
chemical_list: D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D003009:Clorazepate Dipotassium; D003708:Nordazepam; D003975:Diazepam