Abstracts

Rationale: Recreational drugs are thought to raise the risk of seizures and have been considered as part of the etiology of provoked seizures. Whether or not they directly influence the seizure control or interact with prescribed antiseizure medications is still unclear. Cannabinoids have been used as part of the treatment of epilepsy with very limited scientific data supporting its use in humans as an antiseizure agent. The objective of this study is to analyze the relationship between recreational drug (alcohol, cannabinoids, heroin, cocaine, ecstasy, amphetamines) use and seizure control in epilepsy patients. We also evaluated the prevalence of recreational drug use in patients admitted to the EMU in our institution and established associations between frequency of seizures, type of epilepsy and use of recreational drugs. Methods: We reviewed the medical records from our Epilepsy Center at the Cleveland Clinic Florida. Patients were selected by final diagnosis at discharge: Generalized epilepsy, localization related epilepsy, partial complex seizures, and seizure disorder. We were able to review 118 charts of patients with Epilepsy from July 2010 to July 2012. Since it is a retrospective study, the control group was defined as the group of patients with negative drug screen and the cases were defined as the patients with a positive drug screen or with history of recreational drug use. We investigated the following variables in the cases and controls: age, race, gender, BMI (body mass index), frequency of seizures, and type of epilepsy (focal/partial, generalized, temporal and frontal lobe epilepsy. The strength of the association between seizure control, the number of medications and the recreational drugs was assessed by means of chi square analysis, t-test and odds ratio. Results: The study population was composed of 118 patients: 31 cases were positive for drug screen whereas 87, controls, were negative. The prevalence of recreational drugs in the epilepsy unit was 26.27%. The mean age was 41 (SD=13) in the cases and 41 (SD=15.4) in the controls. There were 36.8% (32) males in the control group and 38.7% (12) males in the cases. Patients using recreational drugs suffered, on average, significantly fewer seizures than controls (t(90.86) = -2.75 (p<0.05)). We found a significant association between the number of antiseizure medication that the patient was taking and the use of recreational drugs, ( 2(1) = 7.25, p < 0.05) (OR=3.17; CI, 1.34-7.4). Patients using cannabinoids did not have a significant difference regarding the frequency of the seizure compared with patients with a negative drug screen (t(20.6) = -1.39, p > 0.05). Cannabinoids use (OR=3.92; CI: 1.15-13.78) was significantly associated with treatment with more than 2 antiseizure medications. Conclusions: In the present study, we reported that patients who use recreational drugs suffer fewer seizures. Patients using recreational drugs and especially cannabinoids require treatment with more than one antiseizure medication. We did not find any significant benefit in patients using cannabinoids regarding the seizure frequency.