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Clorazepate and phenobarbital as antiepileptic drugs

A double-blind study

Regional Epilepsy Center, Department of Neurological Surgery, School of Medicine, University of Washington, Seattle, WA.

The antiepileptic effect of clorazepate when given with phenytoin was compared, in a randomized double-blind crossover study, to the effect of the standard regimen of phenobarbital plus phenytoin in patients with partial seizures. Thirty of 42 subjects preferred the clorazepate-phenytoin regimen (p <0.01). The same number of subjects had fewer seizures while taking clorazepate as had fewer seizures while taking phenobarbital. However, subjects had significantly more toxicity, objective and subjective, on the phenobarbital-phenytoin regimen (p <0.01 in both cases). In some subjects, increased toxicity due to phenobarbital outweighed better seizure control, so that clorazepate was preferred. As an add-on antiepileptic drug, clorazepate is well tolerated, effective, and preferred by most patients to phenobarbital.

Address correspondence and reprint requests to Dr. Wilensky, Epilepsy Center ZA-50, Harborview Medical Center, Seattle, WA 98104.

This study was supported by NIH Contracts N01-NS-0-2281 and N01-NS-6-2341, awarded by the National Institute of Neurological and Cornrnunicative Disorders and Stroke.

Presented in part at the thirty-first annual meeting of the American Academy of Neurology, Chicago, IL, April 1979.

Accepted for publication February 4, 1981.

This article has been cited by other articles:

				J. B. Shofer and N. R. Temkin Comparison of Alternative Outcome Measures for Antiepileptic Drug Trials Arch Neurol, September 1, 1986; 43(9): 877 - 881. [Abstract] [PDF]