Treatment of drug-induced seizures

Hsien Yi Chen, Timothy E Albertson, Kent R. Olson

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

Seizures are a common complication of drug intoxication, and up to 9% of status epilepticus cases are caused by a drug or poison. While the specific drugs associated with drug-induced seizures may vary by geography and change over time, common reported causes include antidepressants, stimulants and antihistamines. Seizures occur generally as a result of inadequate inhibitory influences (e.g., gamma aminobutyric acid, GABA) or excessive excitatory stimulation (e.g. glutamate) although many other neurotransmitters play a role. Most drug-induced seizures are self-limited. However, status epilepticus occurs in up to 10% of cases. Prolonged or recurrent seizures can lead to serious complications and require vigorous supportive care and anticonvulsant drugs. Benzodiazepines are generally accepted as the first line anticonvulsant therapy for drug-induced seizures. If benzodiazepines fail to halt seizures promptly, second line drugs include barbiturates and propofol. If isoniazid poisoning is a possibility, pyridoxine is given. Continuous infusion of one or more anticonvulsants may be required in refractory status epilepticus. There is no role for phenytoin in the treatment of drug-induced seizures. The potential role of ketamine and levetiracetam is promising but not established.

Original languageEnglish (US)
Pages (from-to)412-419
Number of pages8
JournalBritish Journal of Clinical Pharmacology
Volume81
Issue number3
DOIs
StatePublished - Mar 1 2016

Keywords

  • anticonvulsants
  • poisoning
  • seizures

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

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