Benzos for drug induced seizures ?

[clinic]

My pdoc suggested to add clobazam to my clozapine for fixing seizure induced by clozapine.

I have read benzos are not good for long term treatment of epilepsy as it can develop tolerance.

Other option he suggested was to try sodium valproate controlled release, which I'm taking right now.

Should i switch from valproate to benzo ? What should i do ? I'm looking for an effective long term epilepsy med with least side effects.

Edited April 7, 2016 by clinic

[Sloane]

Most Benzodiazepines aren't often used for long-term treatment of Epilepsy these days, but instead used mostly for short term use like during Status or right before seizures to help with the duration. Benzo's have a relatively short half life (on average 20-40 hours), which makes treatment for chronic seizures a little complicated. The use of Clobazam (or other long-acting Benzos) for seizures isn't unheard of though, especially in conjunction with other treatments or medications. Although I am unsure the rules in seizure treatment when the seizures are caused by other medications?

In my opinion? I'd rather not use Benzodiazepines for my own long term seizure treatment. I've always had more trouble than it helped. But that is my own case, and my Neurologists never really considered it an option anyway.

But all-in-all, since your doctor suggested it (who knows your seizures) I don't see why it isn't a plausible option. However I think it would be a REALLY good idea to see a Neurologist (if you haven't already) and do some tests to get a second opinion on seizure treatment.

 

Edited April 8, 2016 by Sloane

[jt07]

Seconding seeing a neurologist for the seizures. I can't tell you what to do, but I would stick with the sodium valproate because it is one of the options given to you by your doctor and also because it is likely better in the long term for the treatment of seizures. But, yeah, I'd see a neurologist.

[melissaw72]

I also think you should see a neurologist.  I think they would know more than your pdoc (although I could be wrong) because they specialize in epilepsy, among lots of other neurological problems.  But for now, I'd take what your DR suggested.

[tryp]

I would definitely see about seeing a neurologist unless your psychiatrist is a neuro-psychiatrist or has specialized training in that area.  Different anti-seizure medications are good for different types of seizures and the prescribing can get quite nuanced.

[clinic]

I found some studies regarding treatment for clozapine induced seizures

This study recommends valproate as antiseizure med for clozapine patients.

https://schizophreniabulletin.oxfordjournals.org/content/24/3/381.full.pdf

This study also recommends valproate as best anti-seizure meds for clozapine patients, but says can also try lamotrigine, gabapentin or topiramate

http://link.springer.com/article/10.1007%2Fs40263-014-0222-y#/page-1

This study recommends valproate or lamotrignine

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736902/

[crtclms]

I'm just going to throw in that my husband, who had intractable seizures until he got into a Stage 3 trial a couple of years ago. He is on Klonopin long term, 1mg at bedtime. But he's also on Lamictal, and Oxy-carbamenzapine (sp?).