Seizure-related emergencies caused by stimulants of abuse have been increas
ing. To better understand the nature of these drug-induced convulsions, we
characterized the seizure patterns associated with high doses of cocaine, a
nd the amphetamine analogs, methamphetamine, methylenedioxymethamphetamine
(MDMA) and 4-methylaminorex. The features of the stimulant-induced seizures
were distinct and included the following: (1) the duration of convulsive a
ctivity was shortest for cocaine and longest for methamphetamine, (2) only
MDMA produced a secondary clonic phase after the initial ictal event, and (
3) 4-methylaminorex manifested a very steep dose-response curve. Differenti
al preventive profiles of anticonvulsant agents on the stimulant-induced se
izures also were observed. For example, cocaine-related seizures were most
effectively prevented by, while methamphetamine-induced seizures were compl
etely refractory to, phenytoin pretreatment. The only anticonvulsants which
appeared to influence methamphetamine-related convulsions were diazepam an
d valproate. A unique feature of 4-methylaminorex was that related seizures
were almost completely blocked by the calcium channel blocker, flunarizine
. (C) 1999 Elsevier Science B.V. All rights reserved.