Clonazepam
It reduces excitability of neurons to decease the amplitute of electrical activity from normal & secondary epileptogenic limbic tissues. It also suppresses the spread of epileptiform discharges.In treatment of typical & atypical abscence infantile spasms, myoclonic epilepsy , atonic seizures, minor motor seizures of childhood, refractory grandmal epilepsy or temporal lobe epilepsy.
According to individual age & clinical response.Infants & children 0.01 to 0.03 mg/ kg body weight daily 3-4 divided dose increased in increment of 0.25 -0.5mg/kg/day. till a max of 0.2 mg /kg body weight/day.Adults initially 1.5mg/day Increased by 0.5mg/dayMax. of 20mg daily. Maintanence dose of 4-8mg daily.
Hypersensitivity to benzodiazepines, respiratory depression, acute pulmonary insufficiency.
Avoid alcohol during treatment. Paediatrics: Reduced dose necessary. Pregancy: Safety not established. Lactation: Contraindicated. Elderly: Reduced dose may be necessary.
Drowsiness somnolence, fatigue, Lethargy. Muscular incoordination, ataxia, hypotonia, muscle weakness,dizziness, Vertigo, Depressive mood, nausea vomitting,anorexia& dispepsia.
Adverse effects of drugs like hydantoins and phenobarbitone may be exacerbated by clonazepam. May be added to other anticonvulsant drugs in treatment resistant patients.