Seizures, drug-induced

There is an increased risk of drug-induced seizures in all patients treated with antipsychotics. The highest risk for antipsychotic-induced seizures is with the use of CPZ or clozapine. Seizures are more likely with initiation of treatment and with the use of higher doses and rapid dose increases. 

Tablets and injection only - For adjunctive treatment of edema due to CHF, drug-induced edema, and centrencephalic epilepsy (petit mal, unlocalized seizures). 

CNS toxicity occurs because isoniazid has structural similarities to pyridoxine (vitamin Be) and can inhibit its actions. This toxicity is dose-related and more common in slow acetylators. Manifestations include peripheral neuropathy, optic neuritis, ataxia, psychosis and seizures. The administration of pyridoxine to patients receiving INH does not interfere with the tuberculostatic action of INH but it prevents and can even reverse neuritis. Hematological effects include anaemia which is also responsive to pyridoxine. In some 20% of patients antinuclear antibodies can be detected but only in a minority of these patients drug-induced lupus erythematosus becomes manifest. 

Drug-induced seizures (in doses >6mg/kg) Contraindicated in bulimics... 

Toxicities are numerous and include nephrotoxicity, hypertension, hyperglycemia, liver dysfunction, hyperkalemia, altered mental status, seizures, and hirsutism. Cyclosporine causes very little bone marrow toxicity. While an increased incidence of lymphoma and other cancers (Kaposi s sarcoma, skin cancer) have been observed in transplant recipients receiving cyclosporine, other immunosuppressive agents may also predispose recipients to cancer. Some evidence suggests that tumors may arise after cyclosporine treatment because the drug induces TGF-B, which promotes tumor invasion and metastasis. 

Lactic acidosis Cyanide, carbon monoxide, ibuprofen, isoniazid, metformin, salicylates, valproic acid any drug-induced seizures, hypoxia, or hypotension... 

Whereas the genetic and kindling models have been widely used to investigate possible neurotransmitter defects that cause different types of epilepsy, rodent models in which seizures are induced by electroshock, or by convulsant drugs such as pentylenetetrazol (also called pentetrazol, leptazol), picrotoxin or bicuculline, are mainly used in screening procedures to identify potential anticonvulsants. 

Interest in the possibility of human Mn deficiency increased in 1979 with the report of Papavasiliou and co-workers (6) that some epileptics were characterized by lower than normal blood concentrations of Mn. Based on the knowledge that Mn deficiency in experimental animals could result in increased susceptibility to electroshock and drug-induced seizures (7), these authors suggested that Mn deficiency could be an etiological factor for epilepsy in some individuals. 

Of 279 patients who presented to a hospital emergency service between 1994 and 1998 with a first tonic-clonic seizure, 17 (6.1%) had seizures that were thought to be drug-related (5). The most common drug-induced causes were cocaine intoxication (6/17) and benzodiazepine withdrawal (5/17) followed by amfebutamone use (4/17). While one amfebutamone-associated seizure occurred in a 26-year-old woman without any other risk factors, the... 

Predisposing factors to neuroleptic drug-induced seizures include an abnormal electroencephalogram, preexisting CNS abnormalities, parenteral administration of high doses, and a family history of seizures or febrile convulsions (168). 

An in vitro technique, claimed to assess the relative risks of neuroleptic drug-induced seizures, was reported to produce striking differences between neuroleptic drugs in spike activity in hippocampal slices. Tentatively, molindone, pimozide, and butaclamol were the safest compounds, based on these in vitro experiments (172). 

Andress DL, Ozuna J, Tirschwell D, Grande L, Johnson M, Jacobson AF, Spain W. Antiepileptic drug-induced bone loss in young male patients who have seizures. Arch Neurol 2002 59(5) 781-6. 

Predisposing factors to neuroleptic drug-induced seizures include an abnormal electroencephalogram. 

Myoclonus and opisthotonos, especially in children (38), and choreoathetosis (39) have been attributed to propofol. However, in experimental studies propofol has been shown to be effective against drug-induced seizures (40,41). It has been suggested that propofol inhibits efferent inhibitory neurons in the midbrain and reticular activating system, producing movements that originate subcortically and in the spinal cord (42). 

Diazepam is used primarily in the treatment of mental anxiety. In addition, it acts as a muscle relaxant for a variety of medical conditions. It may also be used as a sedative-hypnotic and anticonvulsant (e.g., for status epilepticus and drug-induced seizures). Diazepam may also be used to alleviate some of the symptoms associated with the following cholinesterase poisoning, substance abuse withdrawal, antihistamine overdose. Black Widow spider envenomation, and chloroquine overdose. As an anesthetic, diazepam may be used alone or in combination with other drugs for conscious sedation. 

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