Treatment of drug-induced seizures

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

Research output: Contribution to journalArticle

26 Citations (Scopus)

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

Fingerprint

Seizures
Pharmaceutical Preparations
Status Epilepticus
Anticonvulsants
etiracetam
Benzodiazepines
Pyridoxine
Geography
Barbiturates
Poisons
Histamine Antagonists
Isoniazid
Ketamine
Phenytoin
Propofol
Poisoning
gamma-Aminobutyric Acid
Antidepressive Agents
Neurotransmitter Agents
Glutamic Acid

Keywords

  • anticonvulsants
  • poisoning
  • seizures

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

Cite this

Treatment of drug-induced seizures. / Chen, Hsien Yi; Albertson, Timothy E; Olson, Kent R.

In: British Journal of Clinical Pharmacology, Vol. 81, No. 3, 01.03.2016, p. 412-419.

Research output: Contribution to journalArticle

Chen, Hsien Yi ; Albertson, Timothy E ; Olson, Kent R. / Treatment of drug-induced seizures. In: British Journal of Clinical Pharmacology. 2016 ; Vol. 81, No. 3. pp. 412-419.
@article{454ff6abedf1405bb31ee656a7695b08,
title = "Treatment of drug-induced seizures",
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.",
keywords = "anticonvulsants, poisoning, seizures",
author = "Chen, {Hsien Yi} and Albertson, {Timothy E} and Olson, {Kent R.}",
year = "2016",
month = "3",
day = "1",
doi = "10.1111/bcp.12720",
language = "English (US)",
volume = "81",
pages = "412--419",
journal = "British Journal of Clinical Pharmacology",
issn = "0306-5251",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Treatment of drug-induced seizures

AU - Chen, Hsien Yi

AU - Albertson, Timothy E

AU - Olson, Kent R.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - 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.

AB - 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.

KW - anticonvulsants

KW - poisoning

KW - seizures

UR - http://www.scopus.com/inward/record.url?scp=84959134172&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959134172&partnerID=8YFLogxK

U2 - 10.1111/bcp.12720

DO - 10.1111/bcp.12720

M3 - Article

C2 - 26174744

AN - SCOPUS:84959134172

VL - 81

SP - 412

EP - 419

JO - British Journal of Clinical Pharmacology

JF - British Journal of Clinical Pharmacology

SN - 0306-5251

IS - 3

ER -