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- Title
Persistent Hypersomnolence Following Clobazam in a Child With Epilepsy and Undiagnosed CYP2C19 Polymorphism.
- Authors
Hamilton, Katherine E.; Shelton, Chasity M.; Wheless, James; Phelps, Stephanie J.
- Abstract
We describe an 11-year-old female who presented with severe hypersomnolence after receiving 1 week of modest doses of clobazam (CLB). In reviewing the above case, we considered that the hypersomnolence could be related to a pharmacodynamic, pharmacokinetic, or pharmacogenomic issue associated with CLB or to a combination of these factors. Although serum concentrations of CLB and its active metabolite are sensitive to factors that affect cytochrome-dependent metabolism, drug-drug interactions were omitted as a cause of the hypersomnolence. Subsequent DNA analysis of the cytochrome P450 2C19 gene revealed the patient as *2/*2 genotype with poor metabolizer enzyme activity. Because genetic testing of all patients treated with CLB is currently not practical, CLB dose/concentration ratios and pharmacokinetic drug-drug interaction impact models may be indicated. Genetic testing should be considered when an adverse effect suggests the possibility of a polymorphism important to drug metabolism.
- Subjects
CHILDHOOD epilepsy; TREATMENT of epilepsy; DRUG side effects; DROWSINESS; ADVERSE health care events; PHARMACOGENOMICS; DRUG metabolism; CLOBAZAM
- Publication
Journal of Pediatric Pharmacology & Therapeutics, 2020, Vol 25, Issue 4, p320
- ISSN
1551-6776
- Publication type
Case Study
- DOI
10.5863/1551-6776-25.4.320