Core70: Drug-induced adverse reaction: epileptiform seizures

⚡ High-yield / 要点：Many drugs can lower the seizure threshold or cause seizures in overdose/toxicity. Classic exam culprits: bupropion, clozapine, tramadol, fluoroquinolones, imipenem, theophylline, INH.

Main drug causes / 主な原因薬

Group	Examples	High-yield point
Antipsychotics	Clozapine; some anticholinergic antipsychotics	Clozapine is especially seizure-prone at higher doses
Antidepressants	Bupropion, TCAs	Bupropion strongly lowers seizure threshold; TCAs in overdose
Opioids	Codeine, tramadol, meperidine	Tramadol is a classic exam trigger
Antibiotics	Ciprofloxacin and other fluoroquinolones; imipenem/cilastatin	More likely in overdose or susceptible patients
Anticonvulsants	Gabapentin, pregabalin, phenytoin	Can paradoxically cause myoclonus or toxicity-related seizures
Stimulants	Amphetamines, cocaine	CNS stimulation can provoke seizures
Miscellaneous	Theophylline, isoniazid (INH)	Theophylline toxicity and INH are classic causes

Drug discontinuation causing seizures / 中止で起こる発作

• Benzodiazepines:
  • Abrupt withdrawal after long-term use can cause seizures.
• Barbiturates:
  • Similar withdrawal risk.
• Alcohol:
  • Severe withdrawal can include seizures.
• Antiepileptic drugs:
  • Abrupt withdrawal may paradoxically precipitate seizures.
• SSRIs:
  • Abrupt withdrawal, especially shorter half-life drugs like paroxetine, may rarely be associated with seizures.
• Opioids:
  • Withdrawal can occasionally trigger seizures, especially with mixed substance abuse or underlying seizure disorders.

Remember / 覚え方

• Bupropion, clozapine, tramadol, fluoroquinolones, imipenem = classic triggers
• Theophylline toxicity and INH are high-yield
• Abrupt withdrawal of benzos/barbiturates/alcohol can cause seizures