The effect of low-dose clonazepam (CZP) on 24-hour long-term EEG recordings in 15 children with epilepsy was evaluated at the Karolinska Hospital, Stockholm, Sweden. A single IM injection of 0.02 mg/kg/bwt produced a highly significant decrease in epileptiform activity compared to placebo, in a double-blind study. Frequency of seizures decreased in parallel with the beneficial EEG response. Median plasma concentrations of CZP ranged from 18-<14 nM. [1]

COMMENT. Low-dose clonazepam therapy (<0.02 mg/kg/day) can be effective in the control of focal and generalized epilepsy, while reducing the incidence of side effects commonly occurring with higher conventional doses (0.05 mg/kg/d). The development of tolerance is one of the greatest drawbacks of clonazepam therapy from a practical standpoint, an effect that usually leads to the necessity for larger doses and the occurrence of sedation, bronchial hypersecretion, and hyperactivity.