OCCURRENCE OF SEIZURES RELATED TO PSYCHOTROPIC MEDICATION AMONG PSYCHIATRIC-INPATIENTS

Objective: Seizures associated with psychotropic medication are seriou s and reportable adverse drug reactions. This study examined the occur rence of seizures associated with psychotropic medication during psych iatric hospitalization. Methods: Among 10,994 admissions to a psychiat ric teaching hospital over a 30-month period between 1990 and 1993, 29 patients were identified by a specially trained quality assurance nur se as having seizures that were probably related to psychotropic medic ation. These cases were verified by a clinical pharmacist and a psycho pharmacologist. Two patients were excluded, and the records of 27 pati ents were reviewed in detail. Results: Nineteen of the 27 patients (70 percent) whose seizures were related to psychotropic medication had a preexisting seizure disorder and eight had new-onset seizures. Psycho tropic medications were Primarily implicated as being associated with seizures in the cases of three of the 19 patients with preexisting sei zure disorders (15.8 percent) and five of the eight patients with new- onset seizures (62.5 percent). In the group with preexisting seizure d isorders, six patients (32 percent) had subtherapeutic blood levels of antiseizure medication, and four (21 percent) experienced pseudoseizu res. Conclusions: Seizures among inpatients on psychotropic medication were infrequent (.3 percent of psychiatric admissions); the majority (70 percent) occurred in patients with preexisting seizure disorders. Seizures were directly attributed to psychotropic medications in less than .1 percent of admissions.