Tranxene T-Tab (clorazepate dipotassium) is an adjunctive (added) therapy approved by the U. S. Food and Drug Administration (FDA) for the management of partial seizures, treating anxiety disorders, and relieving symptoms of alcohol withdrawal

How Tranxene T-Tab works

The active ingredient of Tranxene T-Tab, clorazepate, belongs to the class of benzodiazepines. Benzodiazepines work as GABA-agonists, molecules that act in a similar way to GABA. GABA is a signaling molecule that binds to GABA receptors found on brain cells and inhibits the cells’ activity. Benzodiazepines bind to one type of GABA receptors called GABAA and thereby mimic GABA’s action. Seizures are the result of the uncontrolled firing of neurons. So, benzodiazepines such as clorazepate work by suppressing this uncontrolled firing.

Tranxene T-Tab in clinical trials

Tranxene T-Tab has not been tested in randomized clinical trials for the treatment of seizures, but a few small studies suggest that epilepsy patients with refractory seizures might benefit from this medication.

In one study that included 31 epilepsy patients with refractory seizures, Tranxene T-Tab was added to the regimen. Of the 31 patients, 18 had partial seizures, and 11 had generalized seizures. Both types of seizures are common in people with Batten disease. The mean initial daily dose of Tranxene T-Tab was 0.31 mg per kilogram (kg) body weight, and the dose was increased until seizures were controlled without adverse effects.

The seizure frequency decreased in half of the patients with partial seizures, in 22.2 percent of them by more than 75 percent. Seizure frequency was reduced by less than 75 percent in 22.2 percent of patients with generalized seizures and underlying Lennox-Gastaut syndrome.

In three patients with partial seizures and in one patient with generalized seizures, the frequency of seizures decreased for a short time (one to three months) and then increased again and could not be controlled with a higher dose.

In another study, 59 epilepsy patients with refractory seizures received Tranxene T-Tab as an add-on therapy. The dose of Tranxene T-Tab was increased until seizures were controlled or side effects appeared. The daily dose of Tranxene T-Tab ranged from 0.4 mg to 2 mg per kg body weight.

In 20 patients, the seizure frequency clearly decreased. In 12 of the 20 patients, an improvement in alertness and attention span was noted.

Additional information

Common side effects of Tranxene T-Tab include drowsiness, sedation, and irritability.

People with narrow-angle glaucoma should not take Tranxene T-Tab. Narrow-angle glaucoma is a condition in which the drainage canals of the eye are blocked, leading to increased internal eye pressure.

Tranxene T-Tab use is associated with an increased risk of suicide. Changes in mood and behavior should  be carefully monitored while taking this medication.

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