Clobazam for treatment of epilepsy

Introduction: The landscape of antiepileptic drugs is constantly evolving with new compounds being released onto the market on a regular basis. Most new agents are, at least initially, approved for use as adjunctive treatment of localization-related (focal) epilepsy, and only rarely are new medications released for other types of epilepsy. Though it has been in use in other countries, clobazam is now approved for use in the USA, and specifically in the treatment of Lennox-Gastaut syndrome, a type of (symptomatic or cryptogenic) generalized epilepsy. Areas covered: This paper discusses the pharmacology of clobazam as well as the definition and nosologic boundaries of Lennox-Gastaut Syndrome. General (adult) neurologists are under the erroneous impression that Lennox-Gastaut syndrome is limited to childhood, and this common misconception indicates a lack of understanding of the group of generalized epilepsies. With this paper, readers will gain a better understanding of the limits of Lennox-Gastaut syndrome and how it evolves with age and what clobazam can contribute to its treatment. Expert opinion: Clobazam offers a new treatment option for patients with refractory epilepsy. It has been found to be a safe, well-tolerated adjunctive antiepileptic medication that has had long-standing international experience in thousands of patients. It is unlikely that clobazam will change treatment strategies radically; nonetheless additional options are always welcome as individual patients can respond to different regimens. Physicians should be comfortable prescribing clobazam because it is a benzodiazepine and has been used extensively outside of the USA.