General Warnings

What Are the Drugs to Avoid In Epilepsy?

Epilepsy is one of the most common neurological conditions, affecting more than 65 million worldwide. For those dealing with epilepsy, the advent of a seizure can feel like a ticking time bomb. It could happen at any time or any place, potentially posing a fatal risk when a seizure strikes during risky situations, such as while driving.

Seizure episodes are a result of excessive electrical discharges in a group of brain cells. Different parts of the brain can be the site of such discharges. Seizures can vary from the briefest lapses of attention or muscle jerks to severe and prolonged convulsions. Seizures can also vary in frequency, from less than 1 per year to several per day.

What are the drugs to avoid in epilepsy?

In order to avoid seizure triggers, patients should always work with their doctors or caregiver to choose the best treatment or medication for optimal seizure control and minimal side effects.

Medications that may trigger or cause seizures include:

  • Diphenhydramine: is an antihistamine mainly used to treat allergies. It can also be used for insomnia, symptoms of the common cold, tremor in parkinsonism, and nausea. It is the active ingredient in Benadryl and other medications that treat colds or allergies. It is also a common ingredient in over-the-counter sleep aids and nighttime medications.

A retrospective study published in the Journal of Clinical Toxicology reported that diphenhydramine was a leading cause of drug-induced seizures in the USA. An experimental animal study demonstrated that diphenhydramine-induced convulsions are dose-dependent. The mechanism of action is thought to be related to the histamine receptor.

  • Pseudoephedrine: is a sympathomimetic drug of the phenethylamine and amphetamine chemical classes. It may be used as a nasal/sinus decongestant, as a stimulant, or as a wakefulness-promoting agent in higher doses. This is the active ingredient in medications like Sudafed and any medications with “D” on the end (Zyrtec D, Claritin D or Mucinex D). Studies have reported that high doses of pseudoephedrine accelerate the onset of seizures
  • Bupropion:  sold under the brand names Wellbutrin and Zyban among others, is an atypical antidepressant primarily used to treat major depressive disorder and to support smoking. Bupropion is associated with a risk of seizure at doses above 450 mg a day, especially in patients with a history of seizure or epileptic disorders. This risk appears much lower in the sustained-release bupropion preparations.
  • Tramadol: sold under the brand name Ultram among others, is an opioid pain medication used to treat moderate to moderately severe pain. When taken by mouth in an immediate-release formulation, the onset of pain relief usually begins within an hour. It is also available by injection. Studies have shown that tramadol-related seizures are short, tonic-clonic seizures that, like other drug-related seizures, are self-limiting. This epileptogenic effect of tramadol occurs at both low and high doses.
  • Oral contraceptives: this group of pregnancy preventing drugs can  reduce the effectiveness of your seizure medication or your seizure medication may reduce the effectiveness of your oral contraceptive. New evidence indicates that oral contraceptives can cause an increase in seizures in women with epilepsy. The epilepsy birth control registry, which surveyed women with epilepsy, found that those using hormonal contraceptives self-reported 4.5 times more seizures than those that did not use such contraceptives.
  • Certain antibiotics: numerous antibiotics can trigger epileptic seizures or status epilepticus by decreasing inhibitory transmission in the brain, thus lowering the seizure threshold. The most potent seizurogenic effect is exerted by penicillins, cephalosporins, fluorochinolons and carbapenems.
  • Energy drinks or excessive caffeine: caffeine is known to induce seizures in susceptible individuals, especially in the sleep-deprived state. No clear link has been described between seizures and energy drinks. Nevertheless, large consumption of energy drinks rich in caffeine, taurine, and guarana seed extract  hould be avoided because it could trigger seizures.

How To Avoid Avoid Medication Induced Seizures In Epilepsy

If you have epilepsy and take medications, it is important to discuss the way your prescriptions might interact with other medicines. Getting regular sleep, controlling stress, and managing potential seizure triggers are all important aspects of successfully managing epilepsy.

There are so many possible drug interactions with epilepsy medications,” says. Experts suggest the following for avoiding drug interactions with epilepsy drugs:

Keep your doctor up to date. If you need to start taking medicines for another condition or have to change any of your doses talk to your doctor before you start.

Be honest. Tell your doctor, dentist, and pharmacist about all the medicines, supplements, vitamins, and herbs you use. Go into appointments with a list so you don’t forget anything.

Don’t assume that “natural” means safe. Many herbal medicines and supplements can interact with medicines for epilepsy. For instance, St. John’s wort can interact with several anticonvulsant medicines. In addition, be careful with birth control pills. Some medicines for seizures can prevent birth control pills from working. Epilepsy drugs known to have this effect include Carbatrol, Dilantin, phenobarbital, Mysoline, Trileptal, and Topamax.

Take special precautions if you’re older. Older people are not only more likely to have epilepsy than other adults, but they’re also more likely to be on long-term medication for other conditions like high blood pressure, diabetes, or heart problems. That increases your risk of interactions.

Watch your diet. Oddly enough, some foods like grapefruit can interact with epilepsy medicines. Ask your doctor for a list of any foods you should avoid. More generally, you should not make radical changes to your eating habits. Some of these popular diets can cause havoc in people with epilepsy.

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