Antipsychotic medication and seizures: a review.
Both first-generation and second-generation antipsychotic medications can lower the seizure threshold, increasing the chances of seizure induction. This article reviews the published literature concerning the seizure-lowering effects of first- and second-generation antipsychotic medication. Unfortunately, rigorously controlled studies are relatively infrequent, and case reports form a large part of the available literature, limiting the confidence with which firm conclusions can be drawn. Of the first-generation antipsychotic medications, chlorpromazine appears to be associated with the greatest risk of seizure provocation, although other first-generation antipsychotics also lower seizure threshold. Conversely, molindone, haloperidol, fluphenazine, pimozide and trifluoperazine are associated with a lower risk of seizure induction. Clozapine is the second-generation antipsychotic most frequently associated with seizures, with risperidone appearing to confer a relatively low risk. Other factors such as history of seizure activity, concurrent use of other drugs that lower seizure threshold, rapid dose titration, slow drug metabolism, metabolic factors and drug-drug interactions appear to increase the chances of an antipsychotic medication inducing seizure activity.
Hedges
Dawson
D
Department of Psychology and the Neuroscience Center, Brigham Young University, Provo, Utah 84602, USA. dawson_hedges@byu.edu
Jeppson
Kreg
K
Whitehead
Paul
P
D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000068180:Aripiprazole; D001569:Benzodiazepines; D002986:Clinical Trials as Topic; D003024:Clozapine / Q000494:pharmacology / Q000627:therapeutic use; D003987:Dibenzothiazepines / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology / Q000627:therapeutic use; D007211:Indoles / Q000494:pharmacology / Q000627:therapeutic use; D000077152:Olanzapine; D010879:Piperazines / Q000494:pharmacology / Q000627:therapeutic use; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000069348:Quetiapine Fumarate; D015363:Quinolones / Q000494:pharmacology / Q000627:therapeutic use; D018967:Risperidone / Q000494:pharmacology / Q000627:therapeutic use; D012640:Seizures / Q000139:chemically induced*; D013844:Thiazoles / Q000494:pharmacology / Q000627:therapeutic use
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D007093:Imidazoles; D007211:Indoles; D010879:Piperazines; D015363:Quinolones; D013844:Thiazoles; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D010890:Pirenzepine; C092292:ziprasidone; D000068180:Aripiprazole; C066304:sertindole; D003024:Clozapine; D018967:Risperidone; D000077152:Olanzapine