What antibiotics increase the seizure threshold?

From the Guidelines

Benzodiazepines increase the seizure threshold.

Relevant Medications

• Benzodiazepines are known to increase the seizure threshold, as stated in the study 1.

Mechanism and Effects

The exact mechanism of how benzodiazepines increase the seizure threshold is not explicitly stated in the provided evidence, but it is a well-established fact in clinical practice.

Clinical Implications

It is essential to consider the potential effects of benzodiazepines on seizure threshold when administering electroconvulsive therapy (ECT) or treating patients with seizure disorders.

Comparison with Other Medications

In contrast to benzodiazepines, other medications like lithium, trazodone, carbamazepine, and theophylline may lower the seizure threshold or have adverse effects when used with ECT, as reported in the study 1.

From the Research

Antibiotics and Seizure Threshold

There are several antibiotics that have been studied in relation to their effect on the seizure threshold.

• The following antibiotics have been found to have a potential epileptogenic effect:
  • Penicillin G 2
  • Cloxacillin 2
  • Cephalothin 2
  • Gentamicin 2
  • Chloramphenicol 2
  • Ciprofloxacin 2
  • Erythromycin 2
  • Ampicillin 2, 3
• On the other hand, some antibiotics have been found to have a protective effect against seizures:
  • Minocycline 4
  • Doxycycline 4
  • Tetracycline 4

Seizure Risk and Antibiotics

The risk of seizures associated with certain antibiotics is still a topic of debate.

• A study found that the incidence of seizures associated with fluoroquinolones is low and does not significantly exceed that of macrolides 5.
• Another study reported two cases of seizures following administration of levofloxacin and ciprofloxacin, suggesting that these antibiotics may have a potential epileptogenic effect 6.
• A case report found that ampicillin/sulbactam aggravated seizures in an elderly patient with status epilepticus 3.

Mechanism of Action

The exact mechanism by which antibiotics affect the seizure threshold is not fully understood.

• It is thought that some antibiotics may have a pro-convulsant effect by altering the balance of neurotransmitters or by inducing electrolyte imbalances 6.
• On the other hand, some antibiotics such as minocycline and doxycycline may have anti-inflammatory and anti-apoptotic effects that could contribute to their anticonvulsant properties 4.