clonazepam / Generic mfg. - LARVOL DELTA

Psychiatric Medications Procurement at Primary Health Centers (PHCs) in Tumkur: Insights from an Effectiveness Implementation Hybrid Randomized Controlled Trial on Mental Health Tele-mentoring of Primary Care Doctors (PCDs). (PubMed, Indian J Psychol Med) - "Within-group analysis over time showed a statistically significant increase in the proportion of PHCs procuring amitriptyline in both the OMHT arm (p = .01) and the TAU arm (p = .03). Additionally, in the OMHT arm, there was a significant increase over time in the proportion of PHCs procuring alprazolam (p = .03) and clonazepam (p = .02). In the between-group comparison of total quantities procured during the combined training and post-training phases, the OMHT arm demonstrated significantly higher procurement of escitalopram (p < .01) and risperidone (p < .01) compared to the TAU arm, indicating greater confidence in prescribing practices of key psychiatric medications among trained PCDs. Clinical Trials Registry of India (CTRI/2024/02/062906)."

Journal • CNS Disorders • Mental Retardation • Psychiatry

What's Hot, What's Not: Review of Pharmacological Options for Managing Burning Mouth Syndrome. (PubMed, Ann Pharmacother) - "Multiple agents with different mechanisms of action may be beneficial in the management of BMS. In the absence of treatment guidelines, providers may refer to this review when managing their patients."

Journal • Review • Pain

Association of Aggression and Anti-seizure Medications in Pediatric Patients: Disproportionality Analysis Using the FDA Adverse Event Reporting System. (PubMed, Eur J Pharmacol) - "Signals of aggression related to different ASMs were identified. Significantly strong signals were observed for perampanel, levetiracetam and brivaracetam. Compared to infants and preschooler, ASMs-associated aggression is more common in school children and teenagers."

Adverse events • Journal • CNS Disorders • Epilepsy • Pediatrics

Treatment approaches in posthypoxic myoclonus: A narrative review with expert opinion. (PubMed, Epilepsia) - "Treatment remains largely empirical and variable, with benzodiazepines and antiseizure medications (e.g., levetiracetam, valproate, clonazepam, perampanel) being commonly used. Acute PHM is a clinically heterogeneous disorder with significant diagnostic and therapeutic challenges. Future research should focus on refining diagnostic criteria and identifying targeted therapies to improve outcomes in this often-fatal condition."

Journal • Review • Cardiovascular • CNS Disorders • Epilepsy • Movement Disorders

Severe cutaneous adverse reactions linked to medications in children and adolescents: a pharmacovigilance study based on the FDA Adverse Event Reporting System database. (PubMed, Int J Clin Pharm) - "SCARs in children and adolescents show distinct patterns, high hospitalization and mortality, and strong links with antiepileptics and anti-infectives. Strengthening pediatric pharmacovigilance, implementing risk-alert systems, and promoting genotype-guided prescribing may help prevent these severe reactions."

Adverse events • Journal • Eosinophilia • Pediatrics • Steven-Johnson Syndrome

When the face twitches: An atypical neurological presentation of spontaneous intracranial hypotension (EHF-EHC 2025) - "He was initially treated with clonazepam without improvement, followed by botulinum toxin type A injections, which resulted in a partial reduction of the spasms...This case underscores the importance of integrating focal neurological deficits with headache syndromes, including rare manifestations of SIH. Considering the long-term complications of venous congestion, an alternative treatment was proposed for both headache and hemifacial spasm."

Alzheimer's Disease • Cardiovascular • CNS Disorders • Hypotension • Otorhinolaryngology • Vascular Neurology

Investigating panic-like defensive behaviors in mice using the beetle mania task. (PubMed, Behav Brain Res) - "Panic-like jumping behavior in the small arena was reduced by pre-treatment with the anti-panic agent clonazepam (0.1mgkg-1 i.p) and enhanced by treatment with FG-7142 (10 or 20mgkg-1 i.p.), an panic-inducing drug. Our findings demonstrate that the BMT in the small arena is a reliable model for evaluating non-respiratory panic-like behaviors and also highlights strain-dependent differences in the expression of these responses, with C57BL/6 mice showing the highest reactivity."

Journal • Preclinical • Bipolar Disorder • CNS Disorders • Mental Retardation • Mood Disorders

Breach rhythm-induced asymmetric post-arousal hypersynchrony mimicking ictal EEG in coma. (PubMed, Clin Neurophysiol Pract) - "Pharmacologic reactivity was assessed with IV clonazepam...Significance: As stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) strictly describe EEG morphology and evolution without reference to the cause, normal arousals/awakenings and their variations must be recognized in comatose patients. Due to the ambiguity of the term "ictal" and its clinical implications, "ictal" could be replaced with "intermittent": Stimulus-Induced Rhythmic or Periodic Intermittent Discharges."

Journal • CNS Disorders • Epilepsy • Musculoskeletal Diseases • Orthopedics • Vascular Neurology

Late Pregnancy Antiseizure Medication Exposure and Offspring Neurodevelopmental Risk: A Multi-Child Cohort Study. (PubMed, Ann Neurol) - "Prenatal exposure to certain ASMs was consistently associated with increased risks of NDDs in offspring. These findings support careful, individualized decision-making regarding prenatal ASM use to minimize neurodevelopmental risks. ANN NEUROL 2025."

Journal • CNS Disorders • Developmental Disorders • Epilepsy • Psychiatry

Analysis of the Prevalence of Alcohol and Psychoactive Substances Among Drivers in the Material from the Department of Forensic Medicine at the Medical University of Bialystok in Poland. (PubMed, Toxics) - "Among the total positive cases, psychoactive substances used alone or in combination included THC-46.3% (range 0.2-20 ng/mL), alcohol-26.8% (range 0.1-4.1‱), amphetamines-20.7% (range 15-2997 ng/mL), opiates-4.3% (morphine 66.0 ng/mL; methadone 174.0 ng/mL; ranges: tramadol 15.0-600.0 ng/mL; fentanyl 45.0-100.0 ng/mL), benzodiazepines-9.8% (ranges: diazepam 55.0-480.0 ng/mL; midazolam 17.0-1200.0 ng/mL; clonazepam 21.0-36.0 ng/mL), stimulants-6.10% (ranges: amphetamine 15.0-2997.0 ng/mL; cocaine 4.0-30.0 ng/mL; benzoylecgonine 38.0-602.0 ng/mL; PMMA 45.0-360.0 ng/mL; MDMA 20.0-75.0 ng/mL; mephedrone 37.5 ng/mL; alfa-PVP 120 ng/mL), psychotropic drugs-3.1% (carbamazepine 8.0-2100.0 ng/mL; zolpidem 233.0 ng/mL; citalopram 320.0 ng/mL; opipramol 220 ng/mL). Among the psychoactive substances most frequently used alone or in combination with others, THC was predominant. Roadside testing, based on effects similar to alcohol intoxication, was mainly conducted on male drivers."

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Case Report: Electroacupuncture combined with transcutaneous auricular vagus nerve stimulation for treating antiseizure medication-resistant juvenile myoclonic epilepsy. (PubMed, Front Psychiatry) - "Despite treatment with sodium valproate and clonazepam, he continued to experience multiple seizures weekly and was unable to attend school due to anxiety...From the second session, electroacupuncture was intensified at GV20, GV24, and GB18 due to initial symptom worsening...The patient resumed school attendance, experienced reduced anxiety regarding seizures, and reported enhanced social engagement. This case suggests that combined electroacupuncture and taVNS may be a promising non-pharmacological adjunct in the treatment of ASM-resistant JME, contributing to improved seizure control and multidimensional QOL outcomes."

Journal • CNS Disorders • Epilepsy • Mood Disorders • Pain • Psychiatry

Case series: Clinical management strategies of pediatric clonazepam poisoning informed by pharmacokinetics. (PubMed, Sci Prog) - "In cases involving large doses or multiple drug overdoses, hemoperfusion may be considered on a case-by-case basis to help reduce plasma drug concentrations; however, further studies are required to confirm its clinical efficacy. Additionally, greater attention to adolescent mental health-particularly during puberty-and enhanced education on medication safety are essential to prevent such poisoning incidents."

Journal • PK/PD data • Retrospective data • Ataxia • CNS Disorders • Critical care • Depression • Movement Disorders • Pediatrics • Psychiatry

Seizure Freedom with Nicotine Patch in a Child with CHRNB2 Mutation and Sleep Related Hyper Motor Epilepsy: A Case Report (AES 2025) - "Incremental increases in levetiracetam to 60mg/kg/day failed to control the child's seizures...Seizures did not respond to 10mg/kg/day lacosamide nor to clonazepam... There have been no other cases in the literature with a pathogenic variant of CHRNB2 heterozygous mutation with SHE, who achieved complete seizure freedom after initiating treatment with transdermal nicotine patch. Our patient's case is a rare example of such a response with supporting video EEG and quantitative EEG evidence."

Case report • Clinical • CNS Disorders • Epilepsy • Infectious Disease

Cenobamate and Brivaracetam Use in Pregnancy and Lactation - A Case Report (AES 2025) - "She previously failed multiple ASMs, including clonazepam, gabapentin, oxcarbazepine, levetiracetam, lamotrigine, zonisamide, and phenytoin, due to inadequate seizure control or intolerable side effects. This case describes a normal pregnancy outcome in a young female with intractable localization-related epilepsy on combination cenobamate and brivaracetam. To our knowledge, this is the first reported pregnancy outcome with this specific ASM combination. This offers reassuring, preliminary evidence that cenobamate and brivaracetam may be safely continued in pregnancy when benefits outweigh risks, especially in intractable epilepsy."

Case report • Clinical • Anesthesia • CNS Disorders • Epilepsy

Temporal Lobe Laser Ablation as Treatment for Epilepsy in Koolen deVries Syndrome: A Case Report (AES 2025) - "Seizure frequency included one to two breakthrough seizures monthly despite polytherapy with ASMs including clonazepam, zonisamide, and lacosamide. This case demonstrates that surgical interventions done for patients with more common forms of epilepsy, such as temporal lobe laser ablations, can also be effective treatment options for patients with Koolen de-Vries Syndrome (KdVS)-associated epilepsy as well. Our patient achieved seizure freedom for at least 12 months following surgery with no significant adverse effects. These findings suggest that surgical evaluation should be considered in KdVS patients with medication-resistant epilepsy and correlating EEG and MRI abnormalities."

Case report • Clinical • CNS Disorders • Developmental Disorders • Dystonia • Epilepsy • Mental Retardation • Movement Disorders • Psychiatry • KANSL1

Rare Case Study of Unverricht-Lundborg Disease in Two Siblings: Insight to Genetics and Phenotypic Expression (AES 2025) - "The current regimen includes clonazepam, valproic acid, felbamate, brivaracetam, and cannabidiol. The younger sibling also requires zonisamide... In cases of stimulus-induced myoclonus, progressive GTCs, and ataxia with cognitive decline, clinicians should consider Progressive Myoclonic Epilepsy type 1 (ULD) and confirm with genetic testing. Antiepileptic polytherapy is required. While stimulus-sensitive myoclonic jerks can be resistant, GTCs may respond favorably to treatment."

Case study • Clinical • Ataxia • CNS Disorders • Depression • Epilepsy • Gastrointestinal Disorder • Movement Disorders • Psychiatry

Cannabidiol Inhibits Phenytoin Clearance and Can Result in Clinical Changes (AES 2025) - "A CBD interaction has been well documented for patients taking clobazam (CLB) but not for PHT...On presentation, he was taking levetiracetam, clonazepam, and PHT (which mom reported minimized the frequency and severity of his tonic-clonic seizures)...Epidiolex (CBD) was initiated according to the standard titration... These two cases show CBD inhibition of PHT metabolism can lead to significant increases in levels and meaningful clinical changes (in one case sz control and in the other drug toxicity). In case 1, clinical benefit may also relate to the increase in CLB metabolite and direct effect of CBD. However, the recurrence of seizures on lowering the PHT dose and the resumption of improved control once PHT was restored suggests the elevated PHT was most significant."

Clinical • Late-breaking abstract • Ataxia • CNS Disorders • Epilepsy • Movement Disorders • Ophthalmology • CYP2C19

Intranasal Diazepam as Preventive Therapy in Drug-Resistant Catamenial Epilepsy (AES 2025) - "All her seizures had perimenstrual exacerbations, but the effect was most pronounced for absence seizures (Day 9 of menstrual cycle) and GTCs (Days 6 to 9 of menstrual cycle.) The patient's seizures were resistant to brivaracetam, lamotrigine, topiramate, cannabinoid at high doses and VNS at maximal settings...She had also failed pulsed clonazepam and acetazolamide for control of catamenial seizures... This case demonstrates the potential effectiveness of scheduled intranasal diazepam as a targeted preventive strategy for catamenial epilepsy. Intranasal diazepam has a prolonged half-life of > 24 hours that facilitates once daily administration.3 By anticipating the predictable timing of seizure clusters in relation to the menstrual cycle, prophylactic administration of diazepam significantly reduced seizure frequency with seizure freedom of absence seizures and GTCs. Tolerance to diazepam and withdrawal seizures are possible adverse effects."

Absence Seizure Disorder • CNS Disorders • Epilepsy

Characterizing the Clinical and Genetic Landscape of KCNT1-Related Disorders (AES 2025) - "However, levetiracetam (P = 0.0369, OR 1.31, CI 1.01-1.68), clonazepam (P < 0.001, OR 1.68, CI 1.29-2.18), and lacosamide (P < 0.001, OR 2.67, CI 1.97-3.60) were each associated with either seizure severity improvement or seizure freedom maintenance. We performed a longitudinal phenotypic reconstruction of the natural history of KCNT1-related disorders, identifying unique features associated with recurrent variants and illustrating the consistent seizure burden over time, which underscores the clinical severity of these disorders. Delineating the natural history of KCNT1-related disorders is critical to the design of future clinical trials."

Clinical • Ataxia • CNS Disorders • Epilepsy

Anti-seizure medication exposures in the VA's Million Veteran Program biobank (AES 2025) - "In the FC, the most common extended ASM exposures were gabapentin (22.9% of FC), clonazepam (3.6%), valproate (3.9%), topiramate (3.4%), pregabalin (3.3%), and lamotrigine (2.3%) (see Figure 1). Exposure to ASMs is common in the MVP biobank: half the cohort was prescribed at least one ASM, and more than a quarter had extended use (refills of more than 365 days' duration). However, a minority of the MVP cohort meets algorithmic criteria for epilepsy; therefore, we conclude that the vast majority of ASMs were prescribed for non-epilepsy indications. The most commonly prescribed ASMs (i.e."

CNS Disorders • Epilepsy • Migraine • Mood Disorders • Neuralgia • Psychiatry • MVP

Examining differences in clinical and demographic characteristics of patients with post-traumatic stress disorder across adult treatment subgroups based on the NeuroBlu database: a non-interventional, retrospective cohort study. (PubMed, BMJ Open) - "In the overall study population, most patients were female, with a high prevalence of psychiatric comorbidities. Demographic and clinical characteristics observed in this study varied across treatment subgroups. These insights may support patient-specific treatment planning and inform health-economic decision models in PTSD."

Journal • Retrospective data • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Post-traumatic Stress Disorder • Psychiatry • Suicidal Ideation

High Anion and High Osmolal Gap Metabolic Acidosis and AKI Requiring CRRT Due to the Coingestion of Gamma-Hydroxybutyrate and Three-Dimensional (3D) Printer Resin (KIDNEY WEEK 2025) - "Case Description A 33-year old male PMHx of depression, substance use disorder, prior Tenofovir use was found unresponsive after presumed ingestion of GHB, 3D printer resin, and Klonopin...This adds to the sparse literature on GHB ingestion. This case also underscores the need for early dialysis in these patients to avoid severe acidosis."

CNS Disorders • Depression • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Psychiatry • Renal Disease

Botulinum Toxin A for Belly Dancer’s Dyskinesia: A Case Report of Symptom and Pulmonary Benefit in a Patient with ILD (ASRA-FALL 2025) - "Background • Belly Dancer’s Dyskinesia (BDD) is a rare movement disorder marked by involuntary, rhythmic contractions of the abdominal wall • Etiologies include central or peripheral neurologic lesions, phrenic nerve irritation, medication effects, and prior abdominal trauma • Symptoms can be distressing and functionally limiting and may affect breathing or digestion • Pharmacologic therapy is often ineffective; botulinum toxin A (BoNT-A) has shown promise in isolated reports but lacks standardized dosing or injection protocols Methods • Written informed consent obtained for publication and academic use • Clinical evaluation: MRI brain/spine, EMG, and neurologic assessment Results • Substantial symptomatic improvement in abdominal spasms • Improved respiratory function and reduced pulmonary complications post-treatment • No adverse reactions to BoNT-A Case Report • 72-year-old woman with: • Interstitial lung disease (ILD) • History of abdominal shingles • GERD s/p Nissen..."

Case report • Clinical • CNS Disorders • Cough • Gastroesophageal Reflux Disease • Herpes Zoster • Infectious Disease • Inflammation • Interstitial Lung Disease • Movement Disorders • Parkinson's Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases • Varicella Zoster

Clinical and etiological characteristics of catatonic disorder due to another medical condition: A retrospective study from a tertiary care center. (PubMed, Clin Neurol Neurosurg) - "Catatonic disorder due to another medical condition appears to present with diverse underlying causes and clinical manifestations. Although benzodiazepines are generally considered the first-line treatment, additional interventions were often needed. These findings underline the importance of clinical awareness and timely management, while further research is required to better understand prognostic factors and to guide treatment strategies."

Journal • Retrospective data • CNS Disorders • Immunology

Stability of 22 Sedative-Type Drugs and Metabolites in Human Urine under Variable pH, Temperature, and Freeze-Thaw Conditions. (PubMed, J Anal Toxicol) - "While compounds such as midazolam, clobazam, and zolpidem remained highly stable, others-including alprazolam, triazolam, and lorazepam-exhibited notable degradation, particularly under acidic pH and elevated temperature. Flunitrazepam and clonazepam showed distinct degradation with the formation of 7-amino metabolites at neutral pH...These findings highlight the importance of compound-specific preservation strategies. In scenarios where analyte identity or sample pH cannot be verified promptly, immediate refrigeration or freezing (ideally at -20 °C), along with minimizing freeze-thaw cycles, is strongly recommended to preserve sample integrity and ensure reliable toxicological interpretation."

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