Evaluation of clorazepate (Tranxene®) as an anticonvulsant—a pilot study

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Abstract
Demethyldiazepam-providing the long-term anticonvulsant effect when diazepam is given orally-is conveniently administered as clorazepate (Tranxene). Clorazepate was compared to phenobarbital as a secondary anticonvulsant in 8 ambulatory, adult outpatients. Stable doses of phenytoin were maintained throughout. Drowsiness was present in all on phenobarbital, but there were no clorazepate-related side effects. Seizure control did not differ for each treatment. Addition of common side effects of phenytoin and phenobarbital limited the attained serum levels of each when used together. Clorazepate doses in the 0.56-mg/kg range gave demethyldiazepam levels in the 1.0-.mu.g/ml range. Induction of metabolism was suggested by falling demethyldiazepam levels despite increasing doses. Clorazepate is an effective, nontoxic secondary anticonvulsant.

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