Kuate C, Gélisse P, Baldy-Moulinier M, Crespel A
Unité Médico-chirurgicale de l'Epilepsie, Hôpital Gui de Chauliac, Montpellier, France.
Rev Neurol (Paris). 2004 Jul;160(6-7):701-3. doi: 10.1016/s0035-3787(04)71021-8.
Bupropion hydrochloride (Zyban) is prescribed for smoking cessation. It is contraindicated in patients with seizure disorders. We report three patients with generalized tonic-clonic seizure that occurred a few days after the intake of this drug.
The first two patients had no personal or family seizure history. They had generalized tonic-clonic seizure after taking bupropion (300 mg per day) for a few days. Acute symptomatic seizures were diagnosed in both cases. The third patient suffered from myoclonic jerks during adolescence, had a history of seizure after high dose codeine treatment and a family seizure history. She had generalized tonic-clonic seizure after taking bupropion 300 mg per day. EEG showed paroxystic generalized activity and photosensitivity, consistent with the diagnosis of juvenile myoclonic epilepsy.
Bupropion can lower seizure threshold. The incidence of seizure at 300 mg per day is 1/1000 patients treated.
Many commonly prescribed drugs can trigger epileptic seizure, bupropion is one of them. When prescribing this drug, this adverse effect must be acknowledged and health practitioners should be aware of this risk.
盐酸安非他酮(畅沛)被用于戒烟治疗。癫痫患者禁用此药。我们报告了3例在服用该药几天后发生全身强直阵挛性发作的患者。
前两名患者无个人或家族癫痫病史。他们在服用安非他酮(每日300毫克)几天后出现全身强直阵挛性发作。两例均诊断为急性症状性癫痫发作。第三名患者在青少年期出现肌阵挛抽搐,有高剂量可待因治疗后癫痫发作史及家族癫痫病史。她在服用每日300毫克安非他酮后出现全身强直阵挛性发作。脑电图显示阵发性全身活动及光敏感性,符合青少年肌阵挛癫痫的诊断。
安非他酮可降低癫痫发作阈值。每日服用300毫克时癫痫发作发生率为每1000例治疗患者中有1例。
许多常用药物可引发癫痫发作,安非他酮是其中之一。开具此药时,必须认识到这种不良反应,医护人员应知晓这一风险。