Review question

This review aimed to evaluate the efficacy and tolerability of clonazepam when used as an add-on therapy for adults and children with refractory focal onset or generalised onset epileptic seizures, when compared with placebo or another antiepileptic agent.

Background

Epilepsy affects about 50 million people worldwide, nearly a quarter of whom have drug-refractory epilepsy. Clonazepam is one of the 1,4-benzodiazepine drugs commonly used in epilepsy management, and recommended for second-line adjunctive treatment for various types of seizures. Previous studies have shown that clonazepam is effective in comparison with placebo when used as a supplement to previous medication for people with an insufficient response to conventional antiepileptic treatment.

Review methods

We searched different databases that contain both published and unpublished results of medical studies. We included only randomised controlled studies (i.e. studies in which participants are randomly allocated to one or more treatments), which are considered the gold-standard of experimental studies in research literature. Two review authors independently selected studies for inclusion, extracted relevant data, and assessed trial quality.

Key results

We found no double-blind randomised controlled trials that considered clonazepam as an add-on therapy for adults and children with refractory focal or generalised onset epileptic seizures, thus its efficacy and safety could not be analysed in this review. There is a need for double-blind randomised controlled trials of clonazepam as an add-on therapy for refractory epilepsy.

The evidence is current to September 2017.