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October 1976

Benzodiazepine Anticonvulsant-Reply

Author Affiliations

Children's Hospital 300 Longwood Ave Boston, MA 02115

Arch Neurol. 1976;33(10):731. doi:10.1001/archneur.1976.00500100065027

In Reply.—  I did not intend to advise against the use of clonazepam in patients with tonic-clonic ("grand mal") and an "approved" type of seizure, and I thank Drs Livingston and Pauli for making this clarification. I also have found clonazepam to be ineffective in controlling tonic-clonic seizures and partial seizures with complex symptoms, although some workers report favorable results.I must disagree, however, with the statement that clonazepam is "ineffective" for absence ("true petit mal") seizures. Double-blind studies performed by Chandra1 and being performed by the National Institutes of Health2 have demonstrated significant reductions in absence seizure frequency and occurrence of 3 hz spike-wave with clonazepam. In addition, there are over 30 uncontrolled studies in the literature that report largely favorable results.The high frequency of side effects with clonazepam described by Livingston and Pauli is similar to my earlier experience and the results of early published trials. With