In general , benzodiazepines act as depressants of the CNS , producing all levels of CNS depression from mild sedation to hypnosis to coma , depending on dose . It is believed that benzodiazepines enhance or facilitate the action of gamma – aminobutyric acid (GABA), the major inhibitory neurotransmitter in the CNS, by causing it to bind more tightly to the GABA type A receptor . By stimulation of GABA receptor in the ascending reticular activating system , benzodiazepines increase inhibition and block both cortical and limbic arousal following stimulation of the brain stem reticular formation . Clobazam reduces the ability of the neuron to depolarize to the threshold required to produce an action potential . Thus , the seizure threshold is raised

Epilepsy – Clobazam may be used as an adjunct in the treatment of epilepsy in association with other antiepileptics. Clobazam is active against partial and generalized seizures in epilepsy of widely differing etiology in patients of all ages but is usually only indicated for adjunctive therapy . Intermittent therapy with clobazam has been used successfully in women with catamenial epilepsy (seizures associated with menstruation). Short – term therapy may also be useful for patients whose epileptic attacks occur in clusters or as cover for special events.
Anxiety – Clobazam is used in the short – term treatment of acute anxiety.
Phantom limb pain – There has been a mention of the complete relief of phantom limb pain refractory to other therapy.

Drowsiness ; Ataxia ; Dizziness ; Behavior disorder ; Confusion ; Mental depression; Lethargy ; Slurred speech ; Tremor ; Anterograde amnesia ; Paradoxical reactions including excitation , agitation , hallucinations , and psychosis ; Rash ; Pruritus; Urticaria ; Weight gain ; Xerostomia; Constipation ; Nausea ; Decreased WBCs and other hematologic abnormalities ; Muscle spasm ; Blurred vision

Hypersensitivity to clobazam or any component of the formulation (cross- sensitivity with other benzodiazepines may also exist) ; Narrow – angle glaucoma ; Pregnancy

Risk – benefit should be considered when the following medical problems exist: Acute alcohol intoxication with depressed vital signs ; History of drug abuse or dependence ; Hepatic function impairment ; Hyperkinesis ; Hypoalbuminemia ; Severe mental depression ; Myasthenia gravis ; Organic brain disorders ; Psychoses ; Severe chronic obstructive pulmonary disease ; Renal function impairment ; Established or suspected sleep apnea; Swallowing abnormality in children . Patients must be cautioned about performing tasks which require mental alertness (eg , operating machinery or driving) . Benzodizepines have been associated with falls and traumatic injury and should be used with extreme caution in patients who are at risk of these events (especially the elderly).

Prolonged concurrent use with addictive medications , especially CNS depressants with habituating potential may increase the risk of habituation ; caution is recommended . Use of alcohol during treatment with a benzodiazepine is not recommended because potentiation of CNS depressant effects and increasing of the risk of apnea . Caution is recommended when another CNS depression- producing medication is used with a benzodiazepine , and dosage of one or both agents should be reduced . When a benzodiazepine is used with an opioid analgesic , the dosage of the opioid analgesic should be reduced by at least one third and administered in small increments . Carbamazepine concentrations may be increased during concurrent use with a benzodiazepine ; monitoring of carbamazepine blood concentrations as a guide to dosage is recommended. Concurrent use of cimetidine, oral estrogen- containing contraceptive , diltiazem , disulfiram , erythromycin , fluoxetine , fluvoxamine , grapefruit juice, itraconazole , ketoconazole , nefazodone , propoxyphene , ranitidine and verapamil may inhibit the hepatic metabolism of benzodiazepines , resulting in increased plasma concentrations . Collapse , sometimes accompanied by respiratory depression or arrest , has been reported in a few patients receiving clozapine concurrently with benzodiazepine . Concurrent use with benzodiazepines may decrease the therapeutic effects of levodopa . Concurrent use with benzodiazepines may decrease the clearance of zidovudine ; the toxicity of zidovudine potentially could be increased . Reports of clobazam increasing levels of carbamazepine , phenytoin , valproate and phenobarbital exist. Delavirdine , gemfibrozil , isoniazid , omeprazole, ticlopidine , ciprofloxacin , clarithromycin , diclofenac , doxycycline , protease inhibitors , quinidine and verapamil may increase the levels /effects of clobazam . Aminoglutethimide , carbamazepine , nafcillin , phenobarbital , phenytoin and rifamycins may decrease the levels/effects of clobazam . Theophylline may partially antagonize some of the effects of benzodiazepines.

Respiratory and cardiovascular status.