clobazam / Generic mfg. - LARVOL DELTA

Use of Purified Cannabidiol in Treatment-Resistant Pediatric Epilepsy: Beyond Lennox-Gastaut Syndrome, Dravet Syndrome, and Tuberous Sclerosis Complex. (PubMed, Pediatr Neurol) - "Among our cohort of treatment-resistant pediatric epilepsy, purified CBD was efficacious in a broad range of pediatric epilepsies and was well tolerated as an adjunctive anti-seizure medication. This medication may be considered in pharmacoresistant pediatric epilepsies in conditions beyond its FDA-labeled indications."

Journal • CNS Disorders • Epilepsy • Insomnia • Pediatrics • Sleep Disorder

Epilepsy with myoclonic-atonic seizures: a comprehensive review with emphasis on current and emerging pharmacotherapies. (PubMed, Expert Rev Neurother) - "Treatment is reviewed hierarchically, from valproate, clobazam, levetiracetam and ethosuximide as commonly used first- and second-line agents to the ketogenic diet, cannabidiol, felbamate, and sulthiame for drug-resistant disease. Although approximately two-thirds of patients with EMAtS achieve seizure remission, a substantial minority experience drug-resistant seizure, intellectual disability, and behavioral comorbidities, underscoring the importance of timely diagnosis, appropriate pharmacotherapy, and early consideration of the ketogenic diet in drug-resistant cases. As precision therapeutics advance, syndrome-based care will increasingly be complemented by treatments tailored to the specific genetic etiology."

Journal • Review • CNS Disorders • Developmental Disorders • Epilepsy • Mental Retardation • CHD2 • SLC2A1 • XBP1

Benzodiazepines use in primary care England: Prescribing patterns and adverse consequences. (PubMed, Br J Clin Pharmacol) - "Benzodiazepine prescribing in England continues to decline, reflecting successful deprescribing policies. However, increasing specialist use, persistent inequities, and drug-specific safety and cost concerns highlight the need for cautious prescribing, enhanced pharmacovigilance and equitable access."

Journal • CNS Disorders • Infectious Disease • Insomnia • Mood Disorders • Novel Coronavirus Disease • Psychiatry • Sleep Disorder

Clobazam and Valproate, but Lamotrigine, a Sodium Channel Inhibitor, Reduce the Incidence of Hyperthermia-Induced Clonic Seizures in Dravet Syndrome Mice: Assessment of Anti-Seizure Effects in Mice Using a Stabilized Ambient Temperature System. (PubMed, Neuropsychopharmacol Rep) - "These results reflect clinical findings that CLB and VPA suppress, but LTG does not suppress seizures in patients with DS. Our data demonstrate the validity of our test system to induce hyperthermia-induced seizures and to evaluate the efficacy of antiseizure medications in Scn1a KI/+ mice."

Journal • Preclinical • CNS Disorders • Epilepsy

Potential Role of CYP3A4 in Determining In Vivo Exposure to Cannabidiol (CBD) and its Active Metabolite 7-OH-CBD: Evidence from an In Vitro Study. (PubMed, Eur J Drug Metab Pharmacokinet) - "ASMs with CYP3A4-inhibitory potential may alter systemic exposure to both CBD and its active metabolite, 7-OH-CBD, as demonstrated in vitro. However, co-administration of CBD with CYP3A4-substrate ASMs or CYP2C19 inhibitors is predicted to result in only modest increases in CBD exposure."

Journal • Preclinical • CNS Disorders • Epilepsy • CYP2C19 • CYP2C9 • CYP3A4

Clobazam in pediatric drug-resistant epilepsy: from pharmacology to clinical practice. (PubMed, Eur J Clin Pharmacol) - "Clobazam demonstrates consistent efficacy as adjunctive therapy in pediatric drug-resistant epilepsy, with the strongest evidence supporting its use in LGS. Individualized treatment informed by CYP2C19 genotyping and therapeutic drug monitoring can optimize clinical outcomes. This review provides a comprehensive reference for the rational clinical use of clobazam."

Journal • Review • CNS Disorders • Epilepsy • Pediatrics • CYP2C19

Intranasal midazolam vs mouth-dissolving clobazam in terminating seizures: A randomized controlled trial. (PubMed, Epilepsia) - "There was no statistically significant difference between intranasal midazolam and mouth-dissolving clobazam for termination of clinical and electrographic seizures. We propose that mouth-dissolving clobazam merits further research as a reasonably efficacious, convenient, and cost-effective alternative to intranasal midazolam for acute termination of pre-hospital seizures."

Journal • CNS Disorders • Epilepsy

Development of a prediction model for levetiracetam plasma concentration in children with epilepsy based on pharmacokinetic characteristics: A comparison of multiple linear regression and complex algorithms (PubMed, Zhong Nan Da Xue Xue Bao Yi Xue Ban) - "After incorporating dose, body weight, renal function, concomitant medications, and routine laboratory indicators, the principal predictable information regarding steady-state trough concentrations of LEV in children with epilepsy could be adequately captured by a multiple linear regression model. Its overall predictive performance, error stability, and clinical interpretability were not inferior to those of complex machine-learning models. The daily weight-normalized dose was the key determinant of steady-state trough LEV concentration, while renal function, albumin, serum potassium, and certain concomitant antiseizure medications further explained individual differences in LEV concentrations. Nevertheless, unexplained interindividual variability remained, potentially owing to factors such as medication adherence and developmental maturation. The model results may provide supportive information for the interpretation of TDM findings and dose adjustment, but their..."

Clinical • Journal • PK/PD data • Retrospective data • CNS Disorders • Epilepsy • Hematological Disorders

Exploratory definition of a clinically meaningful change in intracranial EEG features: Analysis of data from a long-term treatment study of the RNS® System. (PubMed, Epilepsy Behav) - "If LE reductions may serve as a potential biomarker, a threshold associated with meaningful improvement in CSs is paramount. Results from this hypothesis-generating analysis support the use of a ≥ 30% LE reduction as a biomarker associated with clinically meaningful improvement in focal epilepsy."

Journal • CNS Disorders • Epilepsy

Case Report: SMART syndrome mimicking Todd's paralysis after meningioma irradiation. (PubMed, Front Oncol) - "Following multidisciplinary evaluation, the patient required a prolonged dexamethasone taper due to failed initial steroid taper and was initiated on amlodipine with continuation of levetiracetam, zonisamide, and clobazam. MRI at three months showed enhancement resolution with clinical improvement and no recurrent seizures. This case highlights SMART syndrome as a diagnosis of exclusion, notable for its shortened latency in comparison to the reported mean and rare association with meningioma, emphasizing the need for heightened clinical suspicion in patients with prior cerebral irradiation presenting with progressive neurologic deficits."

Journal • Brain Cancer • Cardiovascular • CNS Disorders • Epilepsy • Glioma • Medulloblastoma • Meningioma • Migraine • Oncology • Pain • Solid Tumor

Pediatric developmental epileptic encephalopathies treated with cenobamate: Real-world outcomes across etiologies, syndromes, and seizure types. (PubMed, Epilepsia) - "CNB was associated with sustained effectiveness and acceptable tolerability across pediatric DEEs. Slow weight-based titration and proactive simplification of sodium channel blockers and clobazam may optimize benefit-risk."

Journal • Real-world evidence • CNS Disorders • Epilepsy • Pediatrics

Volumetric Absorptive Microsampling (VAMS) for Therapeutic Drug Monitoring of Antiseizure Medications (ASMs) in Pediatric Patients. (PubMed, Pharmaceuticals (Basel)) - "Here, we compared the concentrations of carbamazepine (CBZ), levetiracetam (LEV), lacosamide (LCS), topiramate (TPR) and the benzodiazepine (BZ) clobazam (CLB) in plasma and VAMS samples. Conversely, a conversion factor based on blood to plasma ratio should be adopted to convert CBZ-Diol, -Epoxi and CLB VAMS results into estimated plasma concentrations. This study confirmed the utility of VAMS for TDM of selected ASMs in pediatric patients during routine clinical practice."

Journal • CNS Disorders • Epilepsy • Pediatrics

POPS or POP02: Pharmacokinetics, Pharmacodynamics, and Safety Profile of Understudied Drugs Administered to Children Per Standard of Care (POPS) (clinicaltrials.gov) - P=N/A | N=5000 | Recruiting | Sponsor: Duke University | Trial completion date: Jul 2027 ➔ Dec 2026 | Trial primary completion date: Mar 2027 ➔ Nov 2026

Trial completion date • Trial primary completion date • ADHD (Impulsive Aggression) • Asthma • Attention Deficit Hyperactivity Disorder • Bronchopulmonary Dysplasia • Cardiovascular • CNS Disorders • Dermatology • Developmental Disorders • Endocrine Disorders • Genetic Disorders • Gynecology • Heart Failure • Hematological Disorders • Hemophilia • Hypertension • Immunology • Infectious Disease • Insomnia • Metabolic Disorders • Nephrology • Novel Coronavirus Disease • Pain • Pneumonia • Psychiatry • Pulmonary Arterial Hypertension • Pulmonary Disease • Rare Diseases • Renal Disease • Respiratory Diseases • Sleep Disorder

DECREASE study: A European pool-analysis of patients with significant reductions in concomitant antiseizure medications in cenobamate Early Access Programs. (PubMed, Epilepsia Open) - "People with highly drug-resistant epilepsy often need to take several antiseizure medications at the same time. Combined data from European Early Access Programs show that about 10% of people treated with cenobamate were able to stop all other antiseizure medications or reduce treatment to cenobamate plus one other medication. Despite this simplification of treatment, one-third of these patients became seizure-free and more than two-thirds experienced at least a 50% reduction in seizure frequency. Within this group, no patients stopped cenobamate because of side effects."

Journal • CNS Disorders • Epilepsy • Fatigue • Otorhinolaryngology • Vertigo

Exploring the impact of controlled substance restrictions on epilepsy care in the United States: A neurologist survey. (PubMed, Epilepsy Behav) - "Respondents reported high rates of medication access issues related to controlled substance restrictions and low rates of ASM misuse. Controlled substance restrictions create practical barriers to reliably obtaining scheduled ASM prescriptions that can result in increased risk of morbidity and mortality. Controlled substance restrictions warrant reevaluation for PWE given the specific risk-benefit tradeoffs for this life-threatening neurologic condition."

Journal • CNS Disorders • Epilepsy

Response to anti-seizure medications in children carrying novel or previously reported HCN1 gene variants. (PubMed, Epilepsia Open) - "We surveyed families whose children had been diagnosed with a rare epilepsy syndrome due to mutations in the HCN1 gene. In reviewing their genetic testing results, we discovered five new gene mutations (variants) that had not been previously reported. We also asked which anti-seizure medications had been most effective: they cited valproate and clobazam as most effective, while lamotrigine and oxcarbazepine made seizures worse."

Journal • CNS Disorders • Developmental Disorders • Epilepsy • Psychiatry

Effect of Concomitant Medications on Adverse Event Frequency, Severity, and Time to Resolution in a Cenobamate Open-Label Trial. (PubMed, Eur J Neurol) - "Patients taking fewer concomitant ASMs reported better tolerability as evidenced by fewer and less severe AEs and faster time to resolution. These findings emphasize the importance of optimizing concomitant ASM regimens through dose adjustments, ASM substitution, and treatment simplification to improve tolerability."

Adverse events • Journal • CNS Disorders • Epilepsy • Fatigue • Pain

Fenfluramine in refractory SCN1A-related 'genetic epilepsy with febrile seizures plus'. (PubMed, BMJ Case Rep) - "After treatment failure with sodium valproate, clobazam and topiramate, low-dose fenfluramine (2.2 mg/day, 0.15 mg/kg/day) achieved seizure freedom maintained for more than 1 year with no adverse effects. This dose is substantially lower than the 0.2-0.7 mg/kg/day used in Dravet syndrome trials, suggesting GEFS+ may require lower therapeutic thresholds."

Journal • CNS Disorders • Epilepsy • Pediatrics • Psychiatry

Infertility treatment in women with epilepsy: A systematic review. (PubMed, Epilepsy Behav) - "Available evidence suggests that ART is feasible in women with epilepsy, with most patients maintaining stable seizure control. Hormonal therapy may affect ASM pharmacokinetics and seizure threshold, thereby warranting close monitoring. Larger prospective studies are needed to better define ASM-specific effects and optimize care."

Journal • Review • CNS Disorders • Epilepsy • Gynecology • Infertility • Sexual Disorders

Exploring the Role of Early Add-On Cenobamate in Uncontrolled Focal Epilepsy: A Critical Appraisal of the Evidence. (PubMed, Neurol Ther) - "Cenobamate may offer substantial benefit in adults with uncontrolled focal epilepsy, with a favorable efficacy-tolerability balance, high retention, and possible advantages when introduced earlier (after two ASMs). Its interaction profile underscores the importance of careful management of concomitant ASMs. Because the comparative signals derive largely from non-randomized data, prospective controlled research is needed to confirm any benefit of early use and to better characterize long-term cognitive and psychiatric effects."

Clinical • Journal • Review • CNS Disorders • Epilepsy • Psychiatry

Antiseizure medication dosing and monitoring in the intensive care unit: a practical narrative review. (PubMed, Intensive Care Med) - "The use of ASMs in the ICU require a distinct approach from outpatient settings. Severity of illness, organ dysfunction and replacement devices, and frequent drug-drug interactions warrant tailored agent selection, dosing, and monitoring."

Journal • Review • CNS Disorders • Critical care • Epilepsy

Neurologists' Views on the Management of Uncontrolled Epilepsy in Spain: A Preliminary Survey. (PubMed, Neurol Ther) - "There is a discrepancy between neurologists' treatment goals and their acceptance of persistent seizures in Spanish neurological practice. Several factors may be limiting the achievement of early seizure freedom, including short patient consultations and a lack of familiarity with new treatments, especially among epilepsy non-specialists. Addressing these barriers could improve outcomes for people with uncontrolled epilepsy."

Journal • CNS Disorders • Epilepsy

From synaptic dysfunction to targeted intervention: a comprehensive review of STXBP1 encephalopathy and precision therapeutic strategies. (PubMed, Epilepsy Behav) - "Current management is empirical, with phenobarbital, clobazam, and ketogenic diet supported by the most consistent retrospective cohort evidence for seizure reduction. Emerging precision approaches include AAV-mediated gene replacement, antisense oligonucleotides, 4-phenylbutyrate, CRISPR-based transcriptional activation, microRNA inhibition, and serotonergic modulation. Advances in natural history studies and biomarker development are accelerating mechanism-based therapies, positioning STXBP1-RD as a leading test case for precision medicine in DEEs."

Journal • Review • Autism Spectrum Disorder • CNS Disorders • Developmental Disorders • Epilepsy • Gene Therapies • Genetic Disorders • Mental Retardation • Movement Disorders • XBP1

Epilepsia Partialis Continua in an Adolescent: A Case of Diagnostic Overshadowing. (PubMed, J Investig Med High Impact Case Rep) - "Treatment with lacosamide and clobazam led to complete resolution of the movements and pain within 24 hours. This case illustrates how psychiatric history can shape diagnostic reasoning and delay recognition of epilepsia partialis continua. Persistent focal motor activity, even when intermittently suppressible or behaviorally ambiguous, should prompt early consideration of this diagnosis and escalation to prolonged video EEG when routine evaluation is inconclusive, enabling accurate diagnosis and effective seizure control."

Journal • CNS Disorders • Epilepsy • Mood Disorders • Obsessive-Compulsive Disorder • Pain • Pediatrics • Psychiatry

Delayed-Onset Cefepime Neurotoxicity in a Patient With Epilepsy and ESRD. (PubMed, Case Rep Med) - "Despite therapeutic clobazam levels and stable metabolic parameters, she experienced multiple seizure episodes during a dialysis session...Following immediate cefepime discontinuation and transition to ceftazidime with optimization of antiepileptic therapy, the patient remained seizure-free for the remainder of hospitalization. This case highlights the diagnostic challenge of cefepime neurotoxicity in patients with multiple comorbidities, particularly those with baseline seizure disorders and renal dysfunction. Clinicians should maintain a high suspicion for CIN in patients with renal impairment presenting with new or worsening seizures, utilize EEG findings and therapeutic drug monitoring when available, and promptly discontinue cefepime when toxicity is suspected."

Journal • Chronic Kidney Disease • CNS Disorders • Epilepsy • Immunology • Inflammatory Arthritis • Lupus • Nephrology • Renal Disease • Systemic Lupus Erythematosus