Psychostimulants and epilepsy.
OBJECTIVE
The aim of this article is to review the literature on the effects of psychostimulants in epileptic subjects in order to reach a consensus statement regarding the use or abuse of these substances.


METHODS
Psychostimulant substances have been considered the drugs that share the ability to produce excitation of the CNS leading to convulsions. The stimulation may be at cortical, brainstem, or spinal levels. In this article, the following cortical stimulants are analyzed and discussed: cocaine, amphetamine and related agents, caffeine, cannabinoids, and psychedelic drugs. This review is based on research done using pharmacological textbooks and Medline.


RESULTS
The use of cocaine is associated with the occurrence of seizures. The reported frequency varies from 1% to 40% of addicted subjects, based on the typology of the considered study. Amphetamines and related drugs rarely induce epileptic seizures at therapeutic doses, but seizures may occur after the first dosing. Caffeine at high doses may induce epileptic seizures because of its adenosine receptor-antagonizing properties. Marijuana, at variance with other psychostimulants, owing to its serotonin-mediated anticonvulsant action, could have a medical use for the treatment of epilepsy. Psychedelic compounds rarely induce epileptic seizures, but the most common clinical CNS complication after ingestion of ecstasy is the occurrence of seizures.


CONCLUSIONS
The use of psychostimulants, except for marijuana, can induce single or multiple seizures in healthy subjects.
Zagnoni
P G
PG
Unità Operativa di Neurologia, ASL 15, Cuneo, Italy.
Albano
C
C
D000662:Amphetamines / Q000009:adverse effects; D002110:Caffeine / Q000009:adverse effects; D002186:Cannabinoids / Q000009:adverse effects*; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D003042:Cocaine / Q000009:adverse effects*; D004827:Epilepsy / Q000503:physiopathology*; D006213:Hallucinogens / Q000009:adverse effects*; D006801:Humans; D012640:Seizures / Q000139:chemically induced*
D000662:Amphetamines; D002186:Cannabinoids; D000697:Central Nervous System Stimulants; D006213:Hallucinogens; D002110:Caffeine; D003042:Cocaine