90 Clorazepate
and the group declared clorazepate dipotassium to be less attractive than di-
azepam orlorazepam.
Drug interactions.Members in a group of recreational drug abusers re-
ported that alcohol boosted clorazepate dipotassium’s effect and that the com-
bination made their mood bleaker, but when subjects in another study took
that combination they felt happier than alcohol normally made them. Another
experiment found that the combination impaired memory, although still an-
other study found that clorazepate alone did not affect memory. In testing
how long the desmethyldiazepam metabolite lasts from a clorazepate dipo-
tassium dose, conflicting results have come from experiments comparing cig-
arette smokers to nonsmokers. Opiates, barbiturates, and monoamine oxidase
inhibitors (MAOIs) found in some antidepressants may boost actions of clora-
zepate dipotassium. Clorazepate dipotassium may boost alcohol’s effects.
Cancer.Animal studies have failed to find evidence of any cancer-causing
potential in clorazepate dipotassium.
Pregnancy.Experiments with pregnant rats and rabbits revealed no im-
pairment of fertility and failed to produce any birth defects attributable to
clorazepate dipotassium. One rat study also found no behavioral conse-
quences from prenatal exposure to the drug, but another rat study discovered
that offspring walked more slowly than normal and also had some learning
difficulty. The drug’s potential for creating human birth defects is unknown.
A case report associates it with fatal lung collapse in a newborn whose mother
had used the drug during pregnancy, and another case report associates the
drug with fatal birth defects. “Association” may mean caution is appropriate,
but it does not demonstrate cause and effect. Breast-feeding mothers are
warned to avoid the drug because its metabolite nordiazepam (which is also
a metabolite of diazepam) passes into the milk and into the infant. The metab-
olite desmethyldiazepam also passes into milk, as does clorazepate dipotas-
sium itself.
Additional scientific information may be found in:Fabre, L.F., and H.P. Putman III. “Depressive Symptoms and Intellectual Functioning
in Anxiety Patients Treated with Clorazepate.”Journal of Clinical Psychiatry 49
(1988): 189–92.
Fujii, T., et al. “Clorazepate Therapy for Intractable Epilepsy.”Brain and Development
9 (1987): 288–91.
Henderson, J.G. “Value of a Single Night-time Dose of Potassium Clorazepate in Anx-
iety: A Controlled Trial Comparison with Diazepam.”Scottish Medical Journal 27
(1982): 292–96.
Moodley, P., S. Golombok, and M. Lader. “Effects of Clorazepate Dipotassium and
Placebo on Psychomotor Skills.”Perceptual and Motor Skills61 (1985): 1121–22.
Zung, W.W. “Effect of Clorazepate on Depressed Mood in Anxious Patients.”Journal
of Clinical Psychiatry48 (1987): 13–14.