Efficacy of clobazam as add-on therapy in patients with refractory partialepilepsy

Purpose: Clobazam (CLB) has an important antiepileptic effect and is less e xpensive than the new antiepileptic drugs (AEDs), but still has not been co nsidered as first-line drug in the treatment of epilepsy. We evaluated the efficacy of CLB as add-on therapy in patients with refractory partial epile psy. Methods: This was an open, retrospective study, conducted at the epilepsy c linic of our university hospital. All patients had chronic epilepsy and wer e being evaluated for epilepsy surgery. CLB was introduced as add-on therap y (starting with 10 mg/ day) in patients with previous failure of at least two AEDs. Information was obtained from clinical notes and follow-up visits . Results: We evaluated 97 patients, 37 men and 60 women. Ages ranged from 15 to 70 years (mean, 35.8 years). Etiology of epilepsy was hippocampal atrop hy in 67 (69%), cortical dysgenesis in nine (9.3%), and other etiologies in nine (9.3%). In 12 (12.3%) patients, the etiology of epilepsy was not iden tified despite clinical and neurologic investigation. Patients used CLB for a period ranging from 1 month to 7 years and 9 months (mean, 16.7 months) with doses ranging from 10 to 60 mg/day (mean, 29.7 mg/day). Seven (7.2%) p atients were seizure free, 48 (49.4%) had greater than or equal to 50% of i mprovement in seizure control, 39 (40.2%) had <50% of improvement in seizur e control, and in three (3.1%), no data were available. Conclusions: We conclude that CLB may have efficacy equivalent to that of t he new AEDs when used as add-on therapy in patients with refractory epileps y. CLB should be considered an economic alternative in the treatment of pat ients with refractory epilepsy.