Department of Neurology, Division of Epilepsy, Albany Medical College, Albany, NY, 12208, USA.
Department of Neurology, Erlanger Health System, Chattanooga, TN, 47308, USA.
Neurol Sci. 2023 Aug;44(8):2883-2888. doi: 10.1007/s10072-023-06765-1. Epub 2023 Mar 25.
To evaluate the tolerability of clobazam in patients with drug-resistant epilepsy aged 50 years and older.
We performed a single center, retrospective chart review of patients at least 50 years of age with drug resistant epilepsy of any type who started clobazam as an add on therapy. Retention rate, safety, and tolerability at 6 and 12 months and last follow-up, and the discontinuation rate due to side effects were analyzed.
A total of 26 patients met inclusion criteria. Mean age was 62 ± 7.1 years, and 69.2% of patients were female. The mean baseline seizure frequency before initiation of clobazam was 2 (range 1-30) seizures per month. The mean total daily dose of clobazam administered was 13 (range 5 to 30) mg/day. At the 12-month follow-up visit after clobazam initiation, 40% of patients were seizure-free and an additional 45% of patients had > 50% reduction in seizure frequency. The mean seizure frequency at 12-month follow-up was 1.5 (range 0-24) seizures per month. The mean total dose of clobazam at 12-month follow-up was 14.25 (range 5 to 25) mg/day. The mean duration of clobazam at last follow was 55.2 ± 27.02 (mean ± SD months) and 18 (69.2%) patients remained on clobazam. Twenty out of 26 (76.9%) patients reported at least one side effect and 6/26 (23%) discontinued the medication within a month of initiation. At last follow-up, 40% remained seizure free on stable dosing.
Clobazam can be a safe and tolerable, add-on treatment older adults with drug-resistant epilepsy. Those who responded tolerated the medication well. Discontinuation due to side effects occurred soon after initiation of therapy.
评估氯巴占在 50 岁及以上耐药性癫痫患者中的耐受性。
我们对至少 50 岁且患有任何类型耐药性癫痫的患者进行了一项单中心回顾性图表研究，这些患者开始使用氯巴占作为附加治疗。分析了 6 个月和 12 个月及最后一次随访时的保留率、安全性和耐受性，以及因副作用而停药的比例。
共有 26 名患者符合纳入标准。平均年龄为 62±7.1 岁，69.2%的患者为女性。在开始使用氯巴占之前，平均基线发作频率为每月 2（范围 1-30）次发作。给予氯巴占的平均日总剂量为 13（范围 5 至 30）mg/天。在开始使用氯巴占后的 12 个月随访时，40%的患者无发作，另外 45%的患者发作频率减少了 50%以上。12 个月随访时的平均发作频率为每月 1.5（范围 0-24）次发作。12 个月随访时的氯巴占平均总剂量为 14.25（范围 5 至 25）mg/天。最后一次随访时氯巴占的平均持续时间为 55.2±27.02（均数±标准差月），18（69.2%）名患者仍在使用氯巴占。26 名患者中有 20 名（76.9%）报告至少有一种不良反应，6/26（23%）名患者在开始治疗后一个月内停药。在最后一次随访时，40%的患者在稳定剂量下无发作。
氯巴占可作为安全且耐受良好的附加治疗药物，用于治疗老年耐药性癫痫患者。那些对药物有反应的患者耐受良好。副作用导致的停药发生在治疗开始后不久。
