The most important drugs decreasing the threshold for epileptic seizures

1. Big picture

The seizure threshold means how easily cortical neurons can generate an epileptic seizure. Some drugs make the brain more excitable or disturb inhibitory neurotransmission, so seizures become more likely.

The key exam sentence:

Drugs that decrease the seizure threshold are especially important in patients with epilepsy, brain lesions, alcohol withdrawal, metabolic disturbances, renal/hepatic failure, sleep deprivation, or previous seizures.

The most important drug groups to remember:

• antidepressants, especially bupropion, tricyclic antidepressants, and clomipramine;
• neuroleptics, especially clozapine and typical antipsychotics;
• opioids, espe