Saturday, August 15, 2009

Drugs that affect the seizure threshold

Antiasthmatics-- aminophylline, theophylline
antibiotics-- inh, metronidazole, penicillin, lindane
antidepressants: buproprion, SSRI, TCA
general anesthesia-- enflurane, ketamine
hormones-- estrogen, esp without progesterone
immunosuppressants-- chlorambucil, cyclosporine
local anesthetics- lidocaine, bupivicaine, procaine
narcotics-- fentanyl, meperidine, pentazocine, propoxyphene
psychostimulants- amphetamines, cocaine, methylphenidate
neuroleptics-- clozapine, phenothiazines, butyrophenones
others-- anticholinergic, anticholinesterase, antihistamine, baclofen, heavy metals, lithium, mefenamic acid, oral hypoglycemics, oxytocin

Seizure risk associated with neuroactive drugs: Data from the WHO adverse drug reactions database; Kumlien E, Lundberg PO; Seizure (Dec 2009)

PURPOSE: To explore the association between the use of neuroactive drugs and reports of epileptic seizures. MATERIAL: Using the WHO adverse drug reactions (ADR) database, VigiBase, we surveyed reports of suspected seizures from 1968 until February 2006. Case reports of ADRs, that were classified as convulsions were collected and compared to the total number of ADRs reported. RESULTS: The total number of ADRs was 7,375,325. The number of convulsive events was 71,471. The ratio of convulsive ADRs to the total number of ADRs reported for each drug was evaluated and expressed as a percentage. The 10 drugs most frequently associated with convulsive ADRs were maprotilene (14.42%), escitaloprame (9.78%), buproprione (9.49%), clozapine (9.0%), chlorprothiexene (8.89%), amoxapine (8.74%), donepezil (8.40%), rivastigmine (6.41%), quetiapine (5.90%) and trimipramine (5.69%). CONCLUSIONS: Based on the reports in VigiBase, ADR reports relating to antidepressants, antipsychotic and cholinomimetic drugs included seizures more often than other neuroactive drugs.

1 comment:

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