• YAKHAK HOEJI
• /
• v.32 no.1
• /
• pp.40-49
• /
• 1988

There is evidence that brain norepinephrine may play a role in experimentally induced seizures in animals. Thus the present experiments were undertaken in an attempt to explore the role of brain norepinephrine in anticonvulsant activity of clonazepam. 6-Hydroxydopamine was given to newborn rats and PTZ-induced seizures were tested $70{\sim}90$ days after birth and the rats were killed for determination of brain norepinephrine 8 days after the seizure test. Depletion of norepinephrine in the rat brain significantly potentiated the PTZ-induced convulsions and antagonized the effect of clonazepam on clonic seizures, tonic seizures and the number of seizures, but the latency to the seizure and the mortality has not been altered. However the 6-hydroxydopamine-induced antagonism of anticonvulsant action was surmountable by increasing the dose of clonazepam. These results show that brain norepinephrine may play an important role in seizure susceptability as well as in the anticonvulsant activity of clonazepam in rats.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.17 no.4
• /
• pp.209-213
• /
• 2014

Purpose: Pathologic aerophagia (PA) may lead to bowel perforation or volvulus in mentally retarded patients. The authors investigated the effects of clonazepam on the management of PA in children with severe to profound mental retardation (MR). Methods: This study was undertaken as a retrospective case analysis of 21 PA patients with MR who were followed for over 12 months and diagnosed as having PA. Patients were assigned to two management groups, that is, to a clonazepam randomized open-labeled, treatment group or a reassurance group. The following were recorded and analyzed; age, response, remission rate to clonazepam treatment, and the side effect of clonazepam. It was defined positive response (response+) as being symptom-free for a whole week within 1 month of commencing treatment and remission(+) as being symptom-free for a whole month within 6 months of treatment. Results: The average age of the 21 PA children with MR was 10 years and 13 patients were female. Symptom duration before diagnosis of PA was 7 months. Clinical features of the clonazepam-trial group (n=11) and the reassurance group (n=10) were non-significantly different. Response(+) was achieved by 2 patients (18.2%) in the clonazepamtrial group and by no patient in the reassurance group. Remission(+) was achieved by 6 patients (54.5%) in the clonazepam-trial group and by one patient (10%) in the reassurance group (p=0.040). Conclusion: When PA children with MR with severe bowel distention are considered for surgical treatment to prevent acute abdomen, a trial of clonazepam could be recommended.

• Proceedings of the PSK Conference
• /
• 2003.10b
• /
• pp.244.1-244.1
• /
• 2003

We aimed at determining bioavailability of clonazepam, an anxiolytic drug, and developing a simple analysis in human blood using HPLC. A rapid and sensitive HPLC method was developed and validated using reverse-phase C18 column with retension time and limit of quantification of clonazepam being 2.58 min and 5hg/ml, respectively. Quantification was performed at 235 nm with p-hydroxybenzoic acid ethyl ester as internal standard. The method involved a simple extraction. In order to study blood level profile in time, sight volunteers were enrolled and orally took 6 mg clonazepam once. (omitted)

• Journal of Oral Medicine and Pain
• /
• v.41 no.1
• /
• pp.1-6
• /
• 2016

Purpose: To investigate the efficacy of pregabalin for patients with primary burning mouth syndrome (BMS) who are unresponsive to topical clonazepam therapy. Methods: By searching the clinical electronic records from the Department of Oral Medicine, Pusan National University Dental Hospital from 2012 to 2014, a retrospective analysis was performed on patients with primary BMS who were treated with topical clonazepam therapy during this period. Of the patients who were unresponsive to this therapy, 19 patients who were subsequently treated with pregabalin were included in the study. A pain assessment was performed using the 11-point numerical rating scale at first visit, following topical clonazepam therapy, and again after pregabalin therapy. The treatment outcomes were statistically analyzed using the Wilcoxon signed rank test. Results: Following additional pregabalin administration, the mean pain score was slightly reduced. A total of 7 patients reported a marked response (>50% pain reduction), and 3 patients reported a slight reduction in pain. Pain reduction following pregabalin therapy was statistically significant (p<0.05). Conclusions: Pregabalin has a slight therapeutic effect on patients with primary BMS. Therefore, we recommend pregabalin as an alternative drug for BMS patients who are unresponsive to topical clonazepam therapy.

• Journal of Oral Medicine and Pain
• /
• v.34 no.4
• /
• pp.429-433
• /
• 2009

Burning mouth syndrome (BMS) is defined as burning pain in the tongue or other oral mucous membrane associated with normal sign and laboratory findings at least 4 to 6 months. There are many factors that affect this condition and the pain characters are various among the sufferers, so it is difficult to diagnose exactly and treat properly. The cause of BMS is currently unknown. The etiology is presumed to be that it is related with local, systemic and psychogenic factor. The BMS is related with local factor such as allergic reaction, oral fungal infection(candidiasis), parafunctional oral habits and systemic factors such as diabetes mellitus, hypothyroidism, nutritional deficiencies(vitamin $B_{12}$, folic acid), hyposalivation and psychogenic factor such as depression, anxiety, cancerphobia. So clinicians must be aware of these factors and can give proper treatment options to patients. The management of BMS are pharmacologic management, cognitive behavioral therapy and psychotherapy treatment. Clonazepam, gabapentin, amitriptyline, alpha-lipoic acid and capsaicin are used to manage the BMS. Among these, topical clonazepam is reported that the effect is higher than systemic medication and the complications are rare. This case report is about some cases of the effect of topical clonazepam on BMS.

• Journal of Oral Medicine and Pain
• /
• v.37 no.3
• /
• pp.161-167
• /
• 2012

Burning mouth syndrome(BMS) is defined as chronic, painful burning sensation in the oral mucosa. Treatments for BMS include medication and psychiatric interventions. Capsaicin, alpha-lipoic acid, and topical and systemic clonazepam showed more effective in reducing the symptoms of BMS in the previous studies. The purpose of this study is to evaluate of the therapeutic efficacy of systemic clonazepam in BMS and to elucidate the relationships between such a efficacy and various clinical features, including age, pain intensity, pain duration, previous dental history and condition of oral mucosa. A retrospective clinical records audit was performed of patients diagnosed with BMS between January 2011 and August 2012. Patients were prescribed 0.5 mg clonazepam two times daily. Pain was assessed by patients on an 11-point numeric rating scale (NRS; 0 to 10) before and 1-2 weeks after systemic administration of clonazepam. The efficacy of clonazepam was evaluated in terms of patient's age, initial pain intensity, pain duration, presence or absence of precipitating event, condition of the tongue, presence or absence of denture. A total of 50 patients (46 women, 4 men) were included in this study. The patients were divided into two or three groups according to above clinical features. The amount of mean NRS reduction in patients with severe initial pain was $3.33{\pm}2.74$, whereas that in patients with mild initial pain was $1.64{\pm}1.54$. The amount of mean NRS reduction in oldest patients was $3.53{\pm}1.94$ (${\geq}$70yrs), and those in another younger patients were $2.88{\pm}1.80$(< 60yrs) and $1.54{\pm}2.86$(60yrs ${\leq}$ age < 70yrs), respectively. It was concluded that the older patients and the patients with higher intensity of initial pain tend to show better efficacy of clonazepam. However, There were no statistically significant differences according to pain duration, presence or absence of precipitating events, tongue fissuring, and wearing dentures.

• Archives of Pharmacal Research
• /
• v.21 no.4
• /
• pp.418-422
• /
• 1998

Aim of this work is to prepare poly(DL-lactide-co-glycolide) (PLGA) nanoparticles by dialysis method without surfactant and to investigate drug loading capacity and drug release. The size of PLGA nanoparticles was 269.9 $\pm$118.7 nm in intensity average and the morphology of PLGA nanoparticies was spherical shape from the observation of SEM and TEM. In the effect of drug loading contents on the particle size distribution, PLGA nanoparticles were monomodal pattern with narrow size distribution in the empty and lower drug loading nanoparticles whereas bi- or trimodal pattern was showed in the higher drug loading ones. Release of clonazepam from PLGA nanoparticles with higher drug loading contents was slower than that with lower loading contents.

• YAKHAK HOEJI
• /
• v.48 no.5
• /
• pp.278-284
• /
• 2004

In order to determine the bioavailability of c1onazepam, an anxiolytic drug, a simple, rapid and sensitive HPLC analysis was developed in healthy Korean volunteers. The analysis system was validated in specificity, accuracy, precision and linearity. The analysis condition we established was 2.58 min and 5 ng/$m\ell$ in retention time and limit of quantitation of c1onazepam, respectively, using reverse-phase C18 column connected to UV detector. Quantitation was performed at 235 nm wave length with p-hydroxybenzoic acid ethyl ester as internal standard. The method involved a simple extraction. In order to study blood level profiles as a function of time, eight volunteers were enrolled and orally took 6 mg clonazepam once. The blood samples were collected from 0 to 120 h after the drug administration. Mean AUC and Cmax value were 1028.17$\pm$568.165 (ng/$m\ell$$.$hr) and 41.25$\pm$10.82 (ng/$m\ell$), respectively. And mean Tmax and T$_{1}$2/ value were 1.08$\pm$0.42 (hr) and 30.78$\pm$3.26 (hr). From the results we determine the pharmacokinetic characteristics of clonazepam in Korean people using a newly developed and useful HPLC method.

• Journal of Oral Medicine and Pain
• /
• v.47 no.3
• /
• pp.126-134
• /
• 2022

Purpose: This study aimed to propose an efficient treatment approach for infection with different candida species. Methods: Fifty-three patients who presented with a chief complaint of oral mucosal pain and exhibited positive candida culture findings were divided into two groups (Candida albicans and non-albicans). Pain, mucosal manifestations, salivary flow rates, durations of disease and treatment, and responses to treatment (nystatin and clonazepam) were investigated in both groups. Results: Patients in the C. albicans group exhibited more prominent clinical characteristics (erythematous lesions, tongue coatings, and hyperalgesia) than those in the non-albicans group. In total, 70% of patients in the non-albicans group showed no abnormalities in the oral mucosa. Patients in the C. albicans group showed increased resistance to nystatin treatment compared to those in the non-albicans group, especially with longer disease durations. The patients resistant to nystatin treatment showed positive responses to clonazepam. Conclusions: Patients with oral mucosal pain should be tested for the presence of Candida, even in the absence of mucosal abnormalities, especially those infected with non-albicans species. If no response to antifungal therapy is observed, treatment with clonazepam should be initiated, especially in patients infected with C. albicans.

• Journal of Oral Medicine and Pain
• /
• v.40 no.3
• /
• pp.130-134
• /
• 2015

$Sj{\ddot{o}}gren's$ syndrome (SS) is an autoimmune disease characterized by an autoimmune exocrinopathy involving mainly salivary and lacrimal glands. Apart from manifestations due to involvement of exocrine glands, patients with SS can present with muscular and neurological manifestations. Here, we report a rare case of a 59-year-old woman with primary SS, who presented with severe general toothache and masticatory muscle myalgia successfully treated with clonazepam. Although it was not certain that these symptoms could be originated from focal muscle dystonia or neurological changes that are associated with primary SS, our case suggested that comprehensive evaluation including neuromuscular examinations in the oral and maxillofacial area is needed in patients with SS.