Role of clobazam in the treatment of epilepsies.

The antiepileptic effect of clobazam was first described in 1973. The main advantages of clobazam as an antiepileptic drug are its fast-onset of action and effect against a wide variety of seizures. Despite sometimes losing its effectiveness after a previous period in which it has been effective, clobazam may keep its antiepileptic effect when used intermittently. Tolerance is much more common with benzodiazepines than the other antiepileptic drugs. Although tolerance to clobazam does occur, sustained responders have been identified, and many patients maintain their controlled seizures for several months. Clobazam is a safe drug, and its efficacy is probably equivalent to that of the new antiepileptic drugs. Therefore, it should be considered as add-on medication in the treatment of epilepsy. Clobazam is rapidly and completely absorbed and can be used intermittently, especially for catamenial epilepsy and in patients with clusters of seizures, but only during periods of seizure exacerbation.