The cognitive and behavioural effects of clobazam and standard monotherapy are comparable. Canadian Study Group for Childhood Epilepsy.
OBJECTIVE
To compare the cognitive and behavioural effects of clobazam versus standard monotherapy in the treatment of childhood epilepsy.


METHODS
A randomized, double-blind, prospective design was carried out at three Canadian pediatric epilepsy centres. This study was part of a larger multi-centre study on the efficacy of clobazam. Children with newly diagnosed epilepsy were assigned randomly to receive clobazam or carbamazepine. Children who had failed previous treatment with carbamazepine were assigned randomly to clobazam or phenytoin. Children who had failed on any other antiepileptic drug were assigned randomly to receive clobazam or carbamazepine. In a subset of patients neuropsychological assessments were carried out at 6 weeks and 12 months after initiation of medication. Intelligence, memory, attention, psychomotor speed, and impulsivity were assessed.


RESULTS
There were no differences between the clobazam and standard monotherapy groups on any of the neuropsychological measures obtained at 6 weeks or 12 months. There was no evidence for a deterioration in performance for those children who remained on clobazam for the entire 12-month study period.


CONCLUSIONS
The cognitive and behavioural effects of clobazam appear to be similar to those of standard monotherapy.
Bawden
H N
HN
IWK Grace Health Centre, Halifax, Nova Scotia, Canada. hbawden@iwkgrace.ns.ca
Camfield
C S
CS
Camfield
P R
PR
Cunningham
C
C
Darwish
H
H
Dooley
J M
JM
Gordon
K
K
Ronen
G
G
Stewart
J
J
van Mastrigt
R
R
D000293:Adolescent; D000294:Adolescent Behavior / Q000187:drug effects*; D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002652:Child Behavior / Q000187:drug effects*; D000078306:Clobazam; D003071:Cognition / Q000187:drug effects*; D004311:Double-Blind Method; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D001569:Benzodiazepines; D000078306:Clobazam; D002220:Carbamazepine