Effect of anxiolytic, antidepressant, and antipsychotic drugs on cocaine-induced seizures and mortality

Macêdo, Danielle Silveira; Santos, Ronaldo Pereira; Belchior, Luciana Dias; Neto, Manoel Andrade; Vasconcelos, Silvânia Maria Mendes; Lima, Vera Targino Moreira; Fonteles, M.M.F.; Viana, Glauce Socorro Barros; Sousa, Francisca Cléa Florenço de

doi:10.1016/j.yebeh.2004.07.012

Cited by 31 publications

(14 citation statements)

References 26 publications

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“…5-HT2 receptor agonists and serotonin reuptake inhibitors have been shown to increase cocaine-induced seizures in animal models, while 5-HT2 antagonists appear to increase the seizure threshold. 16,17,21 Lastly, chronic cocaine use may increase the body's sensitivity to the convulsant effects of the drug through kindling. Cocaine kindling is postulated to be secondary to modified NDMA receptor expression with repeated exposure, resulting in increased glutamate activity in the brain.…”

Section: Discussionmentioning

confidence: 99%

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Cocaine use as an independent predictor of seizures after aneurysmal subarachnoid hemorrhage

Chang

Kowalski²,

Carhuapoma

et al. 2016

JNS

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OBJECT Seizures are relatively common after aneurysmal subarachnoid hemorrhage (aSAH). Seizure prophylaxis is controversial and is often based on risk stratification; middle cerebral artery (MCA) aneurysms, associated intracerebral hemorrhage (ICH), poor neurological grade, increased clot thickness, and cerebral infarction are considered highest risk for seizures. The purpose of this study was to evaluate the impact of recent cocaine use on seizure incidence following aSAH. METHODS Prospectively collected data from aSAH patients admitted to 2 institutional neuroscience critical care units between 1991 and 2009 were reviewed. The authors analyzed factors that potentially affected the incidence of seizures, including patient demographic characteristics, poor clinical grade (Hunt and Hess Grade IV or V), medical comorbidities, associated ICH, intraventricular hemorrhage (IVH), hydrocephalus, aneurysm location, surgical clipping and cocaine use. They further studied the impact of these factors on “early” and “late” seizures (defined, respectively, as occurring before and after clipping/coiling). RESULTS Of 1134 aSAH patients studied, 182 (16%) had seizures; 81 patients (7.1%) had early and 127 (11.2%) late seizures, with 26 having both. The seizure rate was significantly higher in cocaine users (37 [26%] of 142 patients) than in non-cocaine users (151 [15.2%] of 992 patients, p = 0.001). Eighteen cocaine-positive patients (12.7%) had early seizures compared with 6.6% of cocaine-negative patients (p = 0.003); 27 cocaine users (19%) had late seizures compared with 10.5% non-cocaine users (p = 0.001). Factors that showed a significant association with increased risk for seizure (early or late) on univariate analysis included younger age (< 40 years) (p = 0.009), poor clinical grade (p = 0.029), associated ICH (p = 0.007), and MCA aneurysm location (p < 0.001); surgical clipping was associated with late seizures (p = 0.004). Following multivariate analysis, age < 40 years (OR 2.04, 95% CI 1.355–3.058, p = 0.001), poor clinical grade (OR 1.62, 95% CI 1.124–2.336, p = 0.01), ICH (OR 1.95, 95% CI 1.164–3.273, p = 0.011), MCA aneurysm location (OR 3.3, 95% CI 2.237–4.854, p < 0.001), and cocaine use (OR 2.06, 95% CI 1.330–3.175, p = 0.001) independently predicted seizures. CONCLUSIONS Cocaine use confers a higher seizure risk following aSAH and should be considered during risk stratification for seizure prophylaxis and close neuromonitoring.

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Section: Discussionmentioning

confidence: 99%

“…Other substances have the potential to either augment or diminish the convulsive effect of cocaine, depending on the substance and dose. 16 Unfortunately, we had insufficient data to control for this effect.…”

Section: 23mentioning

confidence: 99%

Cocaine use as an independent predictor of seizures after aneurysmal subarachnoid hemorrhage

Chang

Kowalski²,

Carhuapoma

et al. 2016

JNS

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“…Biphasic action of imipramine was observed in mice and cats. Imipramine at lower doses exhibited a protective action in penicillin and estrogen-induced seizures in cats [62], cocaine-induced seizures in mice [63] and MES, but it did not inhibit pentylenetetrazole (PTZ)-induced convulsions in mice [62]. This antidepressant at higher doses aggravated cocaine-induced seizures in mice [63], chemically-and electrically-induced seizures in cats [62], while at doses of above 20-25 mg/kg i.p.…”

Section: Imipraminementioning

confidence: 93%

“…Similarly, fluoxetine exerted pro-or anticonvulsive effect in cocaine-induced seizures in mice. At higher doses this drug aggravated convulsions and increased mortality [63]. Single injection of fluoxetine (10-20 mg/kg i.p.)…”

Section: Fluoxetinementioning

confidence: 99%

Pharmacokinetic/pharmacodynamic considerations for epilepsy – depression comorbidities

Banach

Popławska

Błaszczyk³

et al. 2016

Expert Opinion on Drug Metabolism & Toxicology

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The preclinical data may provide valuable clues on how to combine these two groups of drugs - antidepressant drugs neutral or potentiating the anticonvulsant action of antiepileptics are recommended in this regard. Avoidance of antidepressants clearly decreasing the convulsive threshold or decreasing the anticonvulsant efficacy of antiepileptic drugs (f.e. bupropion or mianserin) in patients with epilepsy is recommended.

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“…From experimental point of view, it was shown two years later that buspirone, using the low Mg2+ induced model epilepsy, was effective in reducing the frequency of occurrence of low magnesium induced field potentials in CA1 and CA3 areas of the hippocampus slice preparation (guinea pigs) in a dose dependent manner 4 . In 2004, Macêdo et al demonstrated that small doses of buspirone protected against cocaine-induced seizures and/or mortality 5 . Recently, the research group led by De Freitas showed that buspirone exerted anticonvulsant effects associated with the inhibition of the development of oxidative stress caused by pilocarpine-induced seizures, suggesting a therapeutic use potential of buspirone in epilepsy treatment 6 .…”

mentioning

confidence: 99%

Antioxidant effect of buspirone in epilepsy: is the case closed?

Scorza

2012

Rev. psiquiatr. clín.

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Effect of anxiolytic, antidepressant, and antipsychotic drugs on cocaine-induced seizures and mortality

Cited by 31 publications

References 26 publications

Cocaine use as an independent predictor of seizures after aneurysmal subarachnoid hemorrhage

Cocaine use as an independent predictor of seizures after aneurysmal subarachnoid hemorrhage

Pharmacokinetic/pharmacodynamic considerations for epilepsy – depression comorbidities

Antioxidant effect of buspirone in epilepsy: is the case closed?

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