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[Bupropion-induced epileptic seizures]
C Kuate1, P Gélisse, M Baldy-Moulinier
1Unité Médico-chirurgicale de l'Epilepsie, Hôpital Gui de Chauliac, Montpellier, France.
Revue Neurologique
|July 13, 2004
Summary
Bupropion, used for smoking cessation, can lower seizure threshold, leading to generalized tonic-clonic seizures in some patients. Healthcare providers should be aware of this risk when prescribing bupropion hydrochloride.
Area of Science:
- Neurology
- Pharmacology
Background:
- Bupropion hydrochloride (Zyban) is a medication prescribed for smoking cessation.
- It is contraindicated in patients with a history of seizure disorders.
- This report details three cases of generalized tonic-clonic seizures occurring shortly after bupropion initiation.
Observation:
- Two patients without prior seizure history experienced generalized tonic-clonic seizures after a few days of 300 mg/day bupropion, diagnosed as acute symptomatic seizures.
- A third patient with a history of adolescent myoclonic jerks, prior seizures, and family history of epilepsy also had generalized tonic-clonic seizures on bupropion 300 mg/day.
- EEG in the third patient revealed paroxysmal generalized activity and photosensitivity, indicative of juvenile myoclonic epilepsy.
Findings:
- Bupropion hydrochloride can significantly lower the seizure threshold.
- The incidence of seizures associated with bupropion at 300 mg/day is approximately 1 in 1000 patients.
Implications:
- Bupropion is one of several commonly prescribed medications that can trigger epileptic seizures.
- Healthcare practitioners must acknowledge and be aware of the potential adverse effect of bupropion on seizure threshold.
- Careful patient selection and monitoring are crucial when prescribing bupropion, especially in individuals with risk factors for seizures.