Benzodiazepines in epilepsy: pharmacology and pharmacokinetics.

Article Details

Citation Copy to clipboard

Riss J, Cloyd J, Gates J, Collins S

Benzodiazepines in epilepsy: pharmacology and pharmacokinetics.

Acta Neurol Scand. 2008 Aug;118(2):69-86. doi: 10.1111/j.1600-0404.2008.01004.x. Epub 2008 Mar 31.

PubMed ID

18384456 [ View in PubMed

]

Abstract

Benzodiazepines (BZDs) remain important agents in the management of epilepsy. They are drugs of first choice for status epilepticus and seizures associated with post-anoxic insult and are also frequently used in the treatment of febrile, acute repetitive and alcohol withdrawal seizures. Clinical advantages of these drugs include rapid onset of action, high efficacy rates and minimal toxicity. Benzodiazepines are used in a variety of clinical situations because they have a broad spectrum of clinical activity and can be administered via several routes. Potential shortcomings of BZDs include tolerance, withdrawal symptoms, adverse events, such as cognitive impairment and sedation, and drug interactions. Benzodiazepines differ in their pharmacologic effects and pharmacokinetic profiles, which dictate how the drugs are used. Among the approximately 35 BZDs available, a select few are used for the management of seizures and epilepsy: clobazam, clonazepam, clorazepate, diazepam, lorazepam and midazolam. Among these BZDs, clorazepate has a unique profile that includes a long half-life of its active metabolite and slow onset of tolerance. Additionally, the pharmacokinetic characteristics of clorazepate (particularly the sustained-release formulation) could theoretically help minimize adverse events. However, larger, controlled studies of clorazepate are needed to further examine its role in the treatment of patients with epilepsy.

DrugBank Data that Cites this Article

Drugs

Lorazepam

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Alprazolam	GABA(A) Receptor (Protein Group)	Protein group	Humans	Yes	Positive allosteric modulator	Details
Clobazam	GABA(A) Receptor (Protein Group)	Protein group	Humans	Yes	Positive allosteric modulator	Details
Clonazepam	GABA(A) Receptor (Protein Group)	Protein group	Humans	Yes	Positive allosteric modulator	Details
Desflurane	GABA(A) Receptor (Protein Group)	Protein group	Humans	Yes	Positive allosteric modulator	Details
Lorazepam	GABA(A) Receptor (Protein Group)	Protein group	Humans	Yes	Positive allosteric modulator	Details

Drug Interactions

Drugs	Interaction
Integrate drug-drug interactions in your software
1,2-Benzodiazepine Voriconazole	The serum concentration of 1,2-Benzodiazepine can be increased when it is combined with Voriconazole.
Bromazepam Voriconazole	The serum concentration of Bromazepam can be increased when it is combined with Voriconazole.
Chlordiazepoxide Voriconazole	The serum concentration of Chlordiazepoxide can be increased when it is combined with Voriconazole.
Clobazam Voriconazole	The serum concentration of Clobazam can be increased when it is combined with Voriconazole.
Clonazepam Voriconazole	The serum concentration of Clonazepam can be increased when it is combined with Voriconazole.