title: Treatment of drug-induced seizures.
abstract: Seizures are a common complication of drug intoxication, and up to 9% of status epilepticus cases are caused by a drug or poison. While the specific drugs associated with drug-induced seizures may vary by geography and change over time, common reported causes include antidepressants, stimulants and antihistamines. Seizures occur generally as a result of inadequate inhibitory influences (e.g., gamma aminobutyric acid, GABA) or excessive excitatory stimulation (e.g. glutamate) although many other neurotransmitters play a role. Most drug-induced seizures are self-limited. However, status epilepticus occurs in up to 10% of cases. Prolonged or recurrent seizures can lead to serious complications and require vigorous supportive care and anticonvulsant drugs. Benzodiazepines are generally accepted as the first line anticonvulsant therapy for drug-induced seizures. If benzodiazepines fail to halt seizures promptly, second line drugs include barbiturates and propofol. If isoniazid poisoning is a possibility, pyridoxine is given. Continuous infusion of one or more anticonvulsants may be required in refractory status epilepticus. There is no role for phenytoin in the treatment of drug-induced seizures. The potential role of ketamine and levetiracetam is promising but not established.
authors.affiliation: California Poison Control System, Department of Clinical Pharmacy, University of California, San Francisco, USA.|Department of Emergency Medicine, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.|Division of Clinical Pharmacology & Toxicology, San Francisco General Hospital, San Francisco, USA.
authors.forename: Hsien-Yi
authors.initials: HY
authors.lastname: Chen
authors.affiliation: California Poison Control System, Department of Clinical Pharmacy, University of California, San Francisco, USA.|Department of Internal Medicine, University of California Davis School of Medicine and Veterans Administration Northern California Health Care System, California.
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Albertson
authors.affiliation: California Poison Control System, Department of Clinical Pharmacy, University of California, San Francisco, USA.|Division of Clinical Pharmacology & Toxicology, San Francisco General Hospital, San Francisco, USA.
authors.forename: Kent R
authors.initials: KR
authors.lastname: Olson
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D006801:Humans; D011041:Poisoning / Q000188:drug therapy*; D012640:Seizures / Q000139:chemically induced* / Q000188:drug therapy*; D013226:Status Epilepticus / Q000139:chemically induced / Q000188:drug therapy*
chemical_list: D000927:Anticonvulsants
keywords: anticonvulsants; poisoning; seizures