A CLINICAL STUDY OF THE BENZODIAZEPINE Ro 5‐4023 (CLONAZEPAM) IN THE TREATMENT OF EPILEPSY

A total of 68 patients with various types of epileptic seizures have been treated with Ro 5-4023 (clonazepam), of these patients 60 between 3 and 27 months. In 50 of these 60 patients Ro 5-4023 was used as a supplement to medication which was insufficiently effective. With this the frequency of seizures was reduced by more than 50 per cent in 26 patients. Ten patients were previously untreated and were given Ro 5-4023 alone. Of these 8 were free from seizures during the period of observation. Satisfactory results in the form of a reduction in the frequency of the only or at least one of several types of seizures were seen in 70 per cent of the cases. A favourable effect was seen both as regards grand mal and psychomotor seizures as well as in 2 out of 4 patients with petit mal. The EEG was improved or normalized in 24 out of 51 cases, in which it was controlled. A previously demonstrated connection between an improvement in the EEG and clinical improvement has not been confirmed. No serious side-effects of the treatment have occurred. Strong sedation during the first stages of the treatment in nearly all the patients made it necessary to start with a small dose (1 mg daily) and to increase this slowly (1/2 to 1 mg every 2 or 3 days) to the maintenance level (3 to 12 mg daily). Cessation of treatment owing to side-effects was only necessary in 6 cases. Ro 5-4023 appears on the whole to be the best anti-epileptic of the benzodiazepine derivatives produced to date.