II. Indications
-
Seizure Disorder (Lennox-Gastaut Syndrome)
- Adjunctive anticonvulsant
III. Mechanism
- Benzodiazepine and partial Gamma-Aminobutyric Acid (GABA) receptor Agonist
- Anticonvulsant, Sedative and Anxiolytic properties
- Binds CNS at the Benzodiazepine-GABA-A-chloride ionophore receptor complex
- GABA affinity becomes increased at receptor site resulting in increased Neuron chloride channel opening
- Hyperpolarizes the Neuron, inhibiting the Action Potential and a decreasing Neuron excitability
IV. Precautions
- Exercise caution in elderly
- Avoid in combination with Opioids and other Sedatives (e.g. other Benzodiazepines)
- May result in respiratory depression or coma
V. Dosing: Seizure Disorder (Lennox-Gastaut Syndrome)
- Available as tablets, oral suspension (2.5 mg/ml) and oral films (Sympazan)
- Film (Sympazan) should be applied to Tongue and allowed to dissolve (do not take with liquids)
- Weight >30 kg (and age >=2 years)
- Start 5 mg orally twice daily
- Increase to 10 mg orally twice daily after 1 week
- Increase to 20 mg orally twice daily after 2 weeks
- Weight <30 kg (and age >=2 years)
- Start 5 mg orally daily
- Increase to 5 mg orally twice daily after 1 week
- Increase to 10 mg orally twice daily after 2 weeks
VII. Safety
- Avoid in Pregnancy
- Use in second and third trimester associated with fetal adverse effects
- Effects include decreased fetal movement, Floppy Infant syndrome and medication dependence and withdrawal
- Unknown Safety in Lactation
VIII. Resources
IX. References
- (2022) Presc Lett, Resource #361206, Antiseizure Medications
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 56-7
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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