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Brain and Nerve No to Shinkei Volume 30, Issue 1 （January 1978）

Brain and Nerve 脳と神経 30巻1号（1978年1月発行）

Japanese English

原著

各種てんかんに対するClonazepamの効果 A CLINICAL STUDY OF THE CLONAZEPAM IN THE TREATMENT OE EPILEPSY 山内俊雄 ¹ , 平林良登 ¹ , 片岡憲章 ¹ , 西堀恭治 ² , 小林義康 ³ , 村田忠良 ⁴ , 小林亮三 ⁵ , 鈴木隆 ⁵ , 高橋三郎 ⁶ , 毛利義臣 ⁷ Toshio Yamauchi ¹ , Yoshito Hirabayashi ¹ , Noriaki Kataoka ¹ , Kyoji Nishihori ² , Yoshiyasu Kobayashi ³ , Tadayoshi Murata ⁴ , Ryozo Kobayashi ⁵ , Takashi Suzuki ⁵ , Saburo Takahashi ⁶ , Yoshiomi Mohri ⁷ ¹北海道大学医学部精神医学教室 ²北海道立緑ケ丘病院 ³市立小樽第二病院精神神経科 ⁴札幌天使病院精神神経科 ⁵国立札幌病院精神神経科 ⁶市立岩見沢総合病院精神神経科 ⁷旭川医科大学精神医学教室 ¹Department of Psychiatry and Neurology Hokkaido University School of Medicine ²Hokkaido Prefectural Midorigaoka Hospital ³Department of Psychiatry and Neurology, Second Otaru City Hospital ⁴Department of Psychiatry and Neurology, Sapporo Tenshi Hospital ⁵Department of Psychiatry and Neurology, Sapporo National Hospital ⁶Department of Neuropsychiatry, Iwamizawa Municipal General Hospital ⁷Department of Psychiatry and Neurology, Asahikawa Medical College pp.107-116

発行日 1978年1月1日 Published Date 1978/1/1

DOI https://doi.org/10.11477/mf.1406204193

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Abstract 文献概要
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I．はじめに

　1969年に，benzodiazepine系薬物であるclonazepam（Ro 5-4023,F．Hoffman-La Roche）に強力な抗けいん作用のあることが確かめられ^12,13），1972年には抗てかん剤としての臨床効果に関するシンポジウムがもたれた^36）。その後，本剤の抗てんかん作川に関する多くの知見が諸外国で報告され，総説的展望^3,41）もなされるに及んで，抗てんかん剤としての本剤の位置もほぼ固まつたかに思われる。

　わが国においても，臨床治験がいくつか報告され，その有効性が論じられてきた^{21,23,24,31,32,35,39,42,45）}。しかしその多くは特定の発作型を対象としており，臨床の実際場面でどのように用いることができるかに関する総合的観点からの検討に乏しいようである。

1) The effect of clonazepam (Ro 5-4023) on various types of seizure was studied in 91 patients (male 41, female 50). Mcst patients were under 20 years of age, 19 on average, and had been suffer-ing from epilepsy since childhood, with the mean duration of disease of 9.6 years. Most of them continuously received other antiepileptic drugs during being treated with clonazepam. Clonazepam was administered doses of 0.25 to 6mg per day (0.004-0.21 mg/kg/day).

2) A finally judged 50-percent-cr-more reduction in seizure frequency was obtained in 70.9% of tonic-clonic convulsicn, 63.6% of focal cortical convulsion, 58.3% cf absence, 50.0% of psycho-motor epilepsy, and 33.3% of tonic spasms. An increase in seizure frequency cr appcarance of new types of convulsion was observed in three cases during the clonazepam administration.

3) The effect of clonazepam on the 50% or more seizure reduction was observed in 77.4% of cases at maximum.

4) The seizure frequency tended to decrease usually within one week after clonazepam admini-stration. In 20.3%, however, the sign of diminu-tion of the efficacy as an increase in the frequency was observed after one to three months, sometimes as early as one week.

5) Through the clonazepam administration, the paroxysmal EEG abnormality seemed to disappear in 19.2%, decrease in 14.1%, remain unchanged in 62.8% and increase in 3.8%.

6) Side effects were observed in 37.4%0. The most common one was drowsiness (30.8%), followed by lethargy, somnolence and appetite changes, but no dangerous side effects were noted. There was no definite relation between the occurrence of side effects and the dose of clonazepam.

7) The utility of clonazepam was evalualed from various viewpoints. Clonazepam was useful in about 50% of patients, especially, effective in cases of seizures with basic diseases.