[Skip to Content]
[Skip to Content Landing]
Article
August 1985

Alternate-Day Clonazepam Treatment of Intractable Seizures

Author Affiliations

From the Division of Pediatric Neurology, University of Minnesota Medical School, Minneapolis, and the Epilepsy Program for Children, Gillette Children's Hospital, St Paul.

Arch Neurol. 1985;42(8):787-788. doi:10.1001/archneur.1985.04210090051014
Abstract

• Several investigations have demonstrated a reduction in benzodiazepine receptor binding after long-term exposure to this class of drugs. Such receptor alterations may contribute to the decreased efficacy of benzodiazepines in the management of convulsive disorders. To minimize receptor alterations, several patients with intractable seizures received alternate-day clonazepam therapy, resulting in improved seizure control. The favorable clinical responses suggest that alternative methods of benzodiazepine administration may circumvent receptor subsensitivity resulting from prolonged drug treatment.

References
1.
Browne TR, Penry JK:  Benzodiazepines in the treatment of epilepsy: A review .  Epilepsia 1973;14:277-310.Crossref
2.
Covi L, Lipman RS, Pattison, et al:  Length of treatment with anxiolytic sedatives and response to their sudden withdrawal .  Acta Psychiatr Scand 1973;49:51-64.Crossref
3.
Greenblatt DJ, Shader RI:  Benzodiazepines in Clinical Practice . New York, Raven Press, 1974.
4.
Wilder BJ, Bruni J: Benzodiazepines:  Diazepam, clonazepam, nitrazepam, chlordiazepoxide, clorazepate, and lorazepam , in Wilder BJ, Bruni J (eds):  Seizure Disorders: A Pharmacological Approach to Treatment . New York, Raven Press, 1981, pp 105-113.
5.
Sher PK, Study RF, Mazetta J, et al:  Depression of benzodiazepine binding and diazepam potentiation of GABA-mediated inhibition after chronic exposure of spinal cord cultures to diazepam .  Brain Res 1983;268:171-176.Crossref
6.
Sher PK:  Reduced benzodiazepine receptor binding in cerebral cortical cultures chronically exposed to diazepam .  Epilepsia 1983;24:313-320.Crossref
7.
Lorentz de Haas AM, Kuilman M:  Ethosuximide and grand mal .  Epilepsia 1964;5:90-96.Crossref
8.
Overstreet DH, Yamamura HI:  Receptor alterations and drug tolerance .  Life Sci 1979; 25:1865-1877.Crossref
9.
Prezioso PJ, Neale JH:  Benzodiazepine receptor binding by membranes from brain cell structures following chronic treatment with diazepam .  Brain Res 1984;288:354-358.Crossref
10.
Rosenberg HC, Chiu TH:  Decreased 3H-diazepam binding is a specific response to chronic benzodiazepine treatment .  Life Sci 1979;24:803-808.Crossref
11.
Shibla DB, Gardell MA, Neale JH:  The insensitivity of developing benzodiazepine receptors to chronic treatment with diazepam, GABA and muscimol in brain cell cultures .  Brain Res 1981;210:471-474.Crossref
12.
DiStefano P, Case KR, Colello GD, et al:  Increased specific binding of [3H] diazepam in rat brain following chronic diazepam administration .  Cell Biol Int Rep 1979;3:163-167.Crossref
13.
Crawley JN, Marangos PJ, Stivers J, et al:  Chronic clonazepam administration induces benzodiazepine receptor subsensitivity .  Neuropharmacology 1982;21:85-89.Crossref
14.
Kurlan R, Shoulson I:  Familial paroxysmal dystonic choreoathetosis and response to alternate-day oxazepam therapy .  Ann Neurol 1983; 13:456-457.Crossref
15.
Bowling AC, DeLorenzo RJ:  Micromolar affinity benzodiazepine receptors: Identification and characterization in the central nervous system .  Science 1982;216:1247-1250.Crossref
×