Safety considerations for patients with epilepsy taking antiepileptic drugs alongside caffeine or other methylxanthine derivatives.
BACKGROUND
Antiepileptic drugs (AEDs) are widely used for the treatment of epilepsy. However, ∼ 30% of patients do not remain seizure free. It is possible that methylxanthine derivatives (e.g., caffeine and theophylline) may partially account for this outcome.


METHODS
Data on the convulsive activity of methylxanthines are reviewed. The negative impact of caffeine and theophylline (or aminophylline) on the protective activity of classic and newer AEDs is also considered. Case report studies indicate that ingestion of caffeine may increase seizure frequency, which returns to baseline when the consumption of coffee or caffeine-rich drinks is terminated. However, the existing data also provide clinical evidence that caffeine may not be a trigger for precipitation of seizure activity and this discrepancy is evaluated.


CONCLUSIONS
Experimental data indicate that caffeine and aminophylline both significantly reduce the anticonvulsant activity of a number of AEDs. Clinical data are controversial. Patients with epilepsy should be advised not to take methylxanthine-containing medications. Caffeine consumption, especially accidental and in huge quantities, should be avoided in patients with epilepsy.
Medical University of Lublin, Department of Pediatrics, Endocrinology and Neurology , Chodzki 2, PL 20-093 Lublin , Poland.
Magdalena
M
Chrościńska-Krawczyk
Iwona
I
Radzik
Barbara
B
Miziak
Stanisław J
SJ
Czuczwar
D000628:Aminophylline / Q000008:administration & dosage / Q000009:adverse effects; D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002110:Caffeine / Q000008:administration & dosage / Q000009:adverse effects*; D003069:Coffee / Q000009:adverse effects; D004347:Drug Interactions; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D013806:Theophylline / Q000008:administration & dosage / Q000009:adverse effects; D014970:Xanthines / Q000008:administration & dosage / Q000009:adverse effects*
D000927:Anticonvulsants; D003069:Coffee; D014970:Xanthines; D000628:Aminophylline; D002110:Caffeine; D013806:Theophylline
caffeine; drug interactions; epilepsy; methylxanthine