Caution in usage of clobazam in elderly patients

Clobazam, one of the newer benzodiazepines, is now used extensively as first add on therapy in focal epilepsy. A 67-year-old diabetic and hypertensive gentleman with a history frontal contusion year ago, presented clustering seizures. He was started clobazam 20 mg, levetiracetam 1000 mg/day. Recurrence seizures prompted dose escalation to 40 The patient developed hepatic encephalopathy his decompensation probably precipitated by use high clobazam. Clobazam thus gradually tapered off along precoma regimen, other supportive measures leading an uneventful recovery. Caution must be taken while administering elderly debilitated patients or those organic brain syndrome they are more prone central nervous system (CNS) depressant activity benzodiazepines. Since requires dealkylation hydroxylation prior conjugation, it should caution involvement.