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Medications that lower seizure threshold include the antidepressant and nicotinic antagonist bupropion, the atypical opioid analgesics tramadol and tapentadol, reserpine, [1] theophylline, [2] antibiotics (fluoroquinolones, imipenem, penicillins, cephalosporins, metronidazole, isoniazid) and volatile anesthetics. So can other factors, including:
Tramadol increases the risk for seizures by lowering the seizure threshold. Using other medications that lower seizure threshold - such as antipsychotic medications , bupropion (an anti-depressant and smoking cessation drug), and amphetamines - can further increase this risk.
Tramadol has several enantiomers, and each forms metabolites after processing in the liver. These tramadol variants have varying activities at the μ-opioid receptor, the norepinephrine transporter, and the serotonin transporter, and differing half-lives, with the metabolites having the best activity. Using tramadol as a starting point, the ...
Bradycardia; Hypertension (high blood pressure); Allergic reactions (e.g. dyspnoea (shortness of breath), bronchospasm, wheezing, angioneurotic oedema) Anaphylaxis; Changes in appetite
Breakthrough seizures are more likely with a number of triggers. [54]: 57 Often when a breakthrough seizure occurs in a person whose seizures have always been well controlled, there is a new underlying cause to the seizure. [55] Breakthrough seizures vary. Studies have shown the rates of breakthrough seizures ranging from 11 to 37%. [56]
Patients whose epilepsy is uncontrolled by their medication (i.e., it is refractory to treatment) are selected to see if supplementing the medication with the new drug leads to an improvement in seizure control. Any reduction in the frequency of seizures is compared against a placebo. [21]