Clonazepam in the treatment of status epilepticus

Abstract

Status epilepticus (SE) is a common and serious neurological disorder. The prognosis of SE may be improved by effectively treating the disorder as early as possible. Clonazepam (CZP) has rarely been included in treatment guidelines for SE; however, this drug has been widely used in the treatment of SE patients and has unique advantages. Here, we elaborate on the clinical application of CZP in the treatment of SE and provide an effective and alternative treatment method for this disorder. We review selected literature, summarize action mechanisms, pharmacokinetics and clinical applications of CZP in the treatment of SE. We found that the effects of CZP are rapid and reliable and that adverse reactions are mild and transient. We conclude that CZP may be safely used to treat SE.

Keywords:

• adverse effects
• clonazepam
• drug therapy
• epilepsy
• seizure
• status epilepticus

Financial & competing interests disclosure

This work was supported by the National Clinical Key Specialty Construction Foundation of China and the National Natural Science Foundation of China (grant number is 81271445). The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Status epilepticus (SE) is a severe neurological disorder. Because the duration of SE is longer and the mortality rate is higher, the rapid termination of seizures may improve the prognosis of this disorder.

• Clonazepam (CZP) is a conventional antiepileptic drug that has been widely used in the treatment of SE. However, CZP has rarely been included in guidelines for treating SE.

• CZP exerts its anti-epileptic function in SE patients by enhancing the inhibitory effect of γ-aminobutyric acid A (GABA) in the brain.

• Several studies have demonstrated that CZP has good efficacy when used in the treatment of generalized convulsive SE, partial SE and absence SE.

• The side effects of CZP in the treatment of SE are mild and transient, and this drug may be used safely.

• CZP has a simple clinical administration, rapid action and good efficacy.

• Additional large, randomized controlled studies regarding the application of CZP in SE treatment are necessary.