Certain medications can lower the seizure threshold and should be used cautiously or avoided in patients with a history of seizures.
Risk of seizure can be further increased if:
- The medication is taken in combination with a medication that inhibits their metabolism, resulting in higher concentrations of the medication in the body
- The patient has underlying liver or renal disease and is unable to eliminate the medication properly
- The medication is taken with alcohol
- The medication is taken with multiple medications that have the potential to lower the seizure threshold
- Other factors that can contribute to lowering the seizure threshold besides medications include: older age, illicit drug use, herbs and supplements, and abrupt withdrawal from certain medications or chronic alcohol use
|Medication Category||Specific Examples|
|Analgesics||Tramadol (Ultram), Tapentadol (Nucynta)|
Fluoroquinolones (eg Ciprofloxacin)
SSRIs/SNRIs (do not increase risk when used at therapeutic doses, but may
increase risk at toxic doses)
|Antipsychotics||Clozapine (higher risk than most other antipsychotics)|
|Hypoglycemics||Any diabetic agent that can cause hypoglycemia|
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