Benzodiazepines for Epilepsy

Examples

Generic Name Brand Name
clobazam Onfi
clonazepam Klonopin
clorazepate Gen-Xene, Tranxene
diazepam Diastat, Valium
lorazepam Ativan
midazolam  

These medicines are used in infants and children but with careful dosage adjustments based on weight and age.

How It Works

Benzodiazepines are minor tranquilizers (sedatives) that prevent or stop seizures by slowing down the central nervous system. This makes abnormal electrical activity less likely.

Why It Is Used

Clonazepam may be used to treat:

IV diazepam and lorazepam are often used to treat prolonged seizures or status epilepticus. Diazepam may be used during short periods of increased, repeated, or prolonged seizures (acute repetitive seizures) in people who are taking other antiseizure drugs for long-term treatment.

How Well It Works

In general, benzodiazepines are not usually the first choice for long-term treatment of epilepsy. Although clonazepam or clorazepate may be quite helpful for a few people, most people do not respond very well to them over the long term.

But occasional use of diazepam to treat seizures can be very effective. Treatment with rectal diazepam within 15 minutes of the beginning of a prolonged seizure or a series of seizures usually ends the seizure activity.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

  • Hives.
  • Confusion.
  • Slurred speech.
  • Thoughts of suicide.

Common side effects of this medicine include:

  • Drowsiness.
  • Dizziness.
  • Memory loss.
  • Tolerance (your body keeps needing more of the medicine to get the same effect).

FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on clonazepam and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide in adults and in children and teens.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

It may take time and careful, controlled adjustments by you and your doctor to find the combination, schedule, and dosing of medicine to best manage your epilepsy. The goal is to prevent seizures while causing as few side effects as possible. After you and your doctor figure out the medicine program that works best for you, make sure to follow your program exactly as prescribed.

Risks linked with long-term use. Long-term use of benzodiazepines can sometimes lead to physical and psychological dependence on the drug (addiction). Use of benzodiazepines may decrease seizures at first. But some people begin to have seizures again after using the drug for weeks or months (tolerance). To control their seizures, they have to increase the dose, which tends to increase side effects. Sudden withdrawal of the drug can cause you to go into status epilepticus or may make your epilepsy worse.

Ease of use. For children or adults who have occasional clusters of seizures (acute repetitive seizures) despite long-term drug therapy, rectal diazepam may be a good choice for treating them at home. It usually stops the series of seizures quickly, and family members can treat the person at home safely and easily. Ending these types of repetitive seizures can prevent status epilepticus and other problems associated with prolonged seizures and can help families avoid emergency room visits when a family member has a long history of acute repetitive seizures.

While taking benzodiazepines, avoid alcohol or any other drugs that are central nervous system depressants.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Taking medicines for epilepsy during pregnancy may increase the risk of birth defects. If you are pregnant, breast-feeding, or trying to get pregnant, talk to your doctor. Medicines may need to be continued if your epilepsy is severe. Your doctor can help weigh the risks of treatment against the risk of harm to your pregnancy.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Credits

By Healthwise Staff
John Pope, MD - Pediatrics
Steven C. Schachter, MD - Neurology
Last Revised August 28, 2013

Last Revised: August 28, 2013

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