Rare but life-threatening aspiration pneumonia related to initiation of clobazam therapy.

Clobazam (CLB) was approved in October 2011 by the United States FDA as an adjunctive therapy for the treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients older than the age of 2. Due to its unique chemical design and selective binding to the alpha-2 GABA-receptor, CLB has a decreased tendency for sedation compared to other benzodiazepines. A recent literature review shows that sedation, hypersalivation (drooling), and behavior changes are the most common side effects of CLB. It has also been shown that a patient's level of consciousness is indirectly related to the risk of aspiration. Hypersalivation is too is a significant predisposing factor for aspiration. In this report, we present three adult patients with epilepsy who had aspiration pneumonia during treatment with CLB. We would like to raise awareness of increased drooling and somnolence in patients with predisposing factors for aspiration such as treatment with CLB and emphasize vigilance in this regard.