Effectiveness and plasma levels of clonazepam in the treatment of absence seizures.
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The clinical effects and plasma levels were investigated in a prospective randomized study when clonazepam (CZP) was administered as a single drug to children with absence seizures.<BR>The patients comprised 20 previously untreated children with absence seizures aged 5 to 10 years, who were newly referred to our pediatric seizure clinic. Seventeen of the 20 patients suffered from absence seizures only, and the other 3 showed generalized tonic-clonic seizures combined with absence seizures.<BR>A daily dose of 0.025mg/kg of CZP was given at first and then the dosage was doubled at weekly intervals until the initial maintenance daily dose of 0.1mg/kg was reached. However, in 3 patients who showed high plasma levels of CZP (50.7-65.7ng/m<I>l</I>), the dosage was decreased to tolerable levels because of continuous parental complaiants of hyperkinetic behavior problem. CZP was prescribed in two divided doses per day. The plasma levels selected for the study were determined 4 weeks after starting the maintenance dosage, and all blood samples were taken 2 to 3 hours after the morn-ing dose.<BR>The maintenance daily dosage of CZP (0.10±0.01mg/kg) gave plasma levels of 44.8±6.3ng/m<I>l</I>.<BR>Of the total of 20 patients, absence seizures were not controlled in one. Generalized tonic-clonic seizures occurred in one patient with no absence seizures, and in another they changed to partial seizures. However, for the period of treatment, ranging from 12 to 56months (mean, 27 months), complete seizure control was obtained in 17 out of the 20 patients on the maintenance dosage.<BR>As a wide range of plasma levels (34.0-56.3ng/m<I>l</I>) was associated with complete freedom from seizures, and the plasma levels of patients who did not respond to CZP also fell to within the same range, it was not possibe to define a therapeutic range for CZP.<BR>In 14 out of the 17 patients who responded well to CZP therapy, paroxysmal discharges seen on EEG had disappeared after 6 months of therapy.<BR>CZP is a drug of choice for the treatment of absence seizures in children.
- 一般社団法人 日本てんかん学会の論文
一般社団法人 日本てんかん学会 | 論文
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