Exacerbation of seizures in medial temporal lobe epilepsy due to an alpha1-adrenergic antagonist.
OBJECTIVE
We describe the first reported case of a proconvulsant effect of an alpha(1)-adrenergic antagonist in humans.


METHODS
A patient with medial temporal lobe seizures (MTLE) had increased seizure frequency after treatment with tamsulosin, an alpha(1)-adrenergic antagonist.


RESULTS
Experimental evidence suggests that noradrenaline, which has inhibitory effects on the excitatory synaptic response, can act as a powerful anticonvulsant. Mostly, alpha(2)-adrenoreceptors, but also alpha(1)-adrenoreceptors, have been implicated in this effect by different experimental models. Clinical reports of a proconvulsant or anticonvulsant effect of drugs that act through the adrenergic pathway are scarce.


CONCLUSIONS
This is the first report of a proconvulsant effect by an alpha(1)-adrenergic antagonist in humans and suggests that alpha(1)-adrenoreceptors may be involved in modulating noradrenergic activity in the limbic region.
Iváñez
Vicente
V
Epilepsy Unit, Neurology Department, Hospital Universitario La Paz, Madrid, Spain. ivanez@telefonica.net
Ojeda
Joaquín
J
D000208:Acute Disease; D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013449:Sulfonamides / Q000009:adverse effects* / Q000627:therapeutic use; D000077409:Tamsulosin
D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin