Research and Clinical Trials on Clonazepam (Klonopin, Rivotril)

By Dr Greg Mulhauser
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This list of current clinical research trials on Clonazepam (Klonopin, Rivotril) is followed by a short set of abstracts from the most recent research articles published on the drug.

Article Contents

Clonazepam (Klonopin, Rivotril) Clinical Research Trials

From our searchable database at ClinicalTrialsFeeds.org, this list includes all the latest information about clinical trials involving Clonazepam (Klonopin, Rivotril).

 

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Current Research Literature on Clonazepam (Klonopin, Rivotril)

Here are abstracts for some of the latest research articles to have appeared on Clonazepam (Klonopin, Rivotril):

Quantitation of benzodiazepines in whole blood by electron impact-gas chromatography-mass spectrometry.

J Anal Toxicol. 2008 Oct; 32(8): 644-52
Tiscione NB, Shan X, Alford I, Yeatman DT
Benzodiazepines are frequently encountered in forensic toxicology. A literature search was conducted to find a simple method using electron impact-gas chromatography-mass spectrometry (EI-GC-MS) to examine whole blood specimens for the most commonly encountered benzodiazepines in the United States. A recently published method was identified in the literature search and used as a starting point for development of a new procedure to be used for routine analysis of forensic toxicology case samples. The procedure was then developed and validated as a rapid and efficient method for the screening and quantitation of benzodiazepines in blood using liquid-liquid extraction and EI-GC-MS in selective ion monitoring mode. Materials and instrumentation common to most forensic toxicology laboratories were utilized while obtaining LODs from 5 to 50 ng/mL and LOQs of 50 ng/mL or less using 1 mL of sample. Target compounds were chosen based on availability and common use in the United States and include diazepam, desalkylflurazepam, nordiazepam, midazolam, oxazepam, temazepam, lorazepam, clonazepam, and alprazolam (relative elution order). The linear range (r(2) > 0.990) was validated from 50 to 1000 ng/mL for all analytes. The CV of replicate analyses at both 50 and 200 ng/mL was less than 4%. Quantitative accuracy was within +/- 16% at 50 ng/mL and within +/- 7% at 200 ng/mL. The validated method provides an efficient procedure for the quantitation of a broad range of the most common benzodiazepines in blood at meaningful limits of detection and quantitation using standard laboratory equipment and a small amount of sample.

Validation of SPE-HPLC determination of 1,4-benzodiazepines and metabolites in blood plasma, urine, and saliva.

J Sep Sci. 2008 Nov 10; 31(21): 3704-3717
Nasir Uddin M, Samanidou VF, Papadoyannis IN
A simple, sensitive, selective, and reproducible RP-HPLC method with DAD detection at 240 nm was developed for the determination of six 1,4-benzodiazepines: bromazepam (BRZ), clonazepam (CLZ), diazepam (DZP), flunitrazepam (FNZ), lorazepam (LRZ), alprazolam (APZ); and two metabolites: alpha-hydroxyalprazolam (HALZ) and alpha-hydroxytriazolam (HTZL) in human plasma, urine, and saliva, using colchicine as internal standard, after SPE using Nexus Varian cartridges. Separation was performed on a Kromasil C(8) (250 mmx5 mm, 5 mum) analytical column with a gradient mobile phase containing methanol, ACN and 0.05 M ammonium acetate. Linearity was held within the range 0.3-20.0 ng/muL, with coefficients of determination (r(2)) better than 0.997. The within- and between-day assay RSD at 2, 4, 8 ng/muL ranged from 0.03 to 4.7% and 0.5 to 7.0%, respectively in standards, from 1.3 to 7.9% and 3.3 to 7.3%, respectively in plasma, from 2.1 to 6.0% and 2.1 to 7.8%, respectively in urine and at 0.5, 1.0, 2.0 ng/muL ranged from 2.22 to 5.8% and 2.2 to 8.1%, respectively, in saliva. The mean relative recoveries were 96.3-108.6, 96.0-108.2, 94.3-107.1, 97.0-107.0% in within-day assay and 96.8-107.7, 94.6-107.6, 93.2-105.8, 96.0-108.6 in between-day assay for standard, plasma, urine, and saliva, respectively. The LOD and LOQ were 0.02-0.47 and 0.07-1.57 ng/muL, respectively.

Apparent seizure and atrial fibrillation associated with paliperidone.

Am J Health Syst Pharm. 2008 Nov 15; 65(22): 2122-5
Schneider RA, Lizer MH
PURPOSE: A case of apparent seizure and atrial fibrillation associated with paliperidone is reported. SUMMARY: A 46-year-old man arrived at the emergency room (ER) via ambulance. Earlier that morning, his wife observed him awakening in a panic, drifting back to sleep, and then subsequently awakening in a panic with an apparent seizure lasting one to two minutes. The episode included tongue biting and urinary incontinence. His medical history included bipolar disorder, diabetes mellitus, hyperlipidemia, and hypertension. The patient's medications included metformin, insulin glargine, insulin lispro, simvastatin, enalapril, escitalopram, lamotrigine, and clonazepam and had not changed for many months except for the recent addition of paliperidone four days before his arrival at the ER. Electrocardiography revealed atrial fibrillation, a ventricular rate of 151 beats/min, a Q-Tc interval of 461 msec, and no significant changes in the ST segment or T wave. He had no chest pain, and all other laboratory test results and vital signs were normal. The patient was admitted for evaluation and given a single oral dose of potassium chloride. Diltiazem i.v. was administered with resultant conversion to normal sinus rhythm, after which the patient's heart rate and Q-Tc interval normalized. The patient was discharged after one day. CONCLUSION: A man taking paliperidone and multiple other drugs experienced atrial fibrillation and a possible seizure. Although these are known adverse effects of atypical antipsychotics, it is unusual to have both events occur concurrently and with low-to-average dosages, and these events have not been associated with paliperidone in published case reports.

Partial seizures and atypical absence seizures as a single ictal event in a patient with Lennox-Gastaut syndrome.

J Child Neurol. 2008 Nov; 23(11): 1319-23
Yang Z, Liu X, Qin J, Zhang Y, Bao X, Xiong H
The authors report a patient with Lennox-Gastaut syndrome who was a fraternal twin. The twins encountered myoclonic seizures at the age of 4 years, but the seizures in the other patient were controlled very quickly without intellectual development damage. With the disease evolving, other characteristic seizures of Lennox-Gastaut syndrome appeared and failed to be controlled by multiple antiepileptic drugs, so levetiracetam was added on. At this time, frequent partial seizures from the left occipital and posterior temporal regions occurred, which always intermixed with atypical absence seizures in a single ictal event. To control the status epilepticus, levetiracetam was withdrawn immediately, and clonazepam, midazolam, and corticotropin in turn were used. The partial seizures were gradually alleviated. The results obtained in this study suggest that there might be some correlative mechanisms between partial seizures and atypical absence seizures in a single event. There is a temporal relationship between the occurrence of partial seizures and the introduction of levetiracetam.

Television-provoked epilepsy in children: a follow-up survey from isfahan, iran.

Arch Iran Med. 2008 Nov; 11(6): 649-53
Etemadifar M, Raoufi M, Maghzi AH, Ebrahimi A, Kaji-Esfahani M, Mousavi SA
BACKGROUND: Television as an external stimulation can precipitate epileptic seizures. Today this kind of epilepsy is known as television epilepsy. As children spend much of their time watching television, it is important to study this type of epilepsy in this age group. This study was designed to describe the clinical and some demographic characteristics of television epilepsy in Iranian children. METHODS: Patients who were diagnosed as having television epilepsy with an age less than 12 years were recruited from outpatient neurology clinics in Isfahan, Iran, from September 2002 through September 2006. We collected the case-related information including electroencephalo-grams, radiologic findings, and patients' history. RESULTS: Thirty patients with television epilepsy with the age less than 12 years were identified. Of whom 17 (56.7%) were females and 13 (43.3%) were males. The mean age at the onset of seizure was 9.9+/-2.1 years. Children had absence (3.3%), myoclonic (3.3%), and generalized tonic-clonic (93.3+/-) seizures in response to intermittent photic stimulations. Interictal epileptiform discharges in electroencephalograms were detected in 83.3%. In addition, neuroimaging findings were normal in 96.7% of the patients. In our study, 56.7% of the children had pure television epilepsy and 43.3% experienced other types of generalized seizure. During the follow-up period after initiation of variable drug treatments including valproic acid, carbamazepine, phenobarbital, clonazepam, ethosuximide, and lamotrigine all the patients had complete seizure remission. CONCLUSON: The clinical and demographic differences of our patients compared with other reports are probably due to genetic differences. In our study, it was demonstrated that carbamazepine could be used in children with television epilepsy because it had successfully terminated seizures in 43.3% of the patients.

 

This page was last reviewed by Dr Greg Mulhauser, Friday, 4 July 2008.

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