Vol 53, No 6 (2019)
Review Article
Published online: 2019-11-04

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Antipsychotic drugs in epilepsy

Natalia Górska1, Jakub Słupski1, Wiesław J. Cubała1
Pubmed: 31681966
Neurol Neurochir Pol 2019;53(6):408-412.

Abstract

The prevalence of various psychiatric disorders in people with epilepsy is high, with psychoses affecting 2–9% of patients. Antipsychotic drugs have been identified as increasing the risk of epileptic seizures. For first-generation antipsychotics such a risk appears to be relatively low, with the exception of chlorpromazine. Among second-generation antipsychotics, clozapine use carries the highest risk of seizure induction, while risperidone, quetiapine, amisulpride, and aripiprazole seem to pose a significantly lower risk. The incidence of an increased number of seizures is linked to the elevated blood plasma level effect of antipsychotics. To diminish the risk of seizures, it is important to start with a small dose of antipsychotic drug, to titrate slowly, to monitor serum levels of prescribed drugs, and to keep the drug at the minimal effective dose.

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