The benzodiazepines are widely used as antiepileptic drugs, as well as for anxiolytic, hypnotic and antispastic indications. The main role in epilepsy for diazepam, lorazepam and midazolam is as acute therapy for status epilepticus, acute seizures and in febrile convulsions, and this is covered on pp. 211-13, 218-21. In chronic epilepsy, in addition to clobazam (pp. 123-6) and clonazepam (pp. 127-9), three other benzodiazepines—diazepam, clorazepate and nitrazepam—still have a minor role.
The benzodiazepines all bind to the GABA-A receptors and exert their antiepileptic action by enhancing inhibitory neurotransmission. Differences between the drugs relate to their differential binding at the receptor and their pharma-cokinetic properties. The similarities between the drugs are greater than the differences (Figure 3.12).
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