Seizures as a complication of recreational drug use: Analysis of the Euro-DEN Plus data-set.

Authors:
David M Wood
David M Wood
University of London
United Kingdom
Alison Dines
Alison Dines
Clinical Toxicology
Greensburg | United States
Christopher Yates
Christopher Yates
Royal Melbourne Hospital
Australia
Fridtjof Heyerdahl
Fridtjof Heyerdahl
Ullevaal University Hospital
Norway
Knut Erik Hovda
Knut Erik Hovda
Ullevaal University Hospital
Norway

Neurotoxicology 2019 Apr 8;73:183-187. Epub 2019 Apr 8.

Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK; Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Seizures are a recognized and potentially serious complication of recreational drug use. This study examined a large international data set of presentations to Emergency Departments with acute recreational drug toxicity, the European Drug Emergencies Plus (Euro-DEN Plus) Network, to compare presentations with and without seizures and estimate incidence and associated drugs. Amongst 23,947 presentations between January 2014 and December 2017, there were 1013 (4.2%) with reported seizures. Clinical and demographic features were similar between individuals who had a seizure and those who did not, although rates of coma, cardiac arrest, intubation, intensive care admission, and death were significantly higher in those with seizures. There was a significant association between specific drugs and a higher seizure incidence, including fentanyl (odds ratio 2.63, 95% confidence interval 1.20-5.80), and synthetic cannabinoids (OR 2.90, 95% CI 2.19-3.84). Other drugs were associated with a lower seizure incidence, including heroin (OR 0.46, 95% CI 0.35-0.61), clonazepam (OR 0.22, 95% CI 0.06-0.91), and cannabis (OR 0.65, 95% CI 0.50-0.86). This substantiates observations that the synthetic cannabinoids as a group of novel psychoactive substances are clinically different in consequence of intoxication than cannabis, and that individuals who suffer a seizure in the context of recreational drug intoxication are likely to have worse outcomes overall. Utilising this information of what substances have a greater risk of seizures, could provide tailored harm reduction and education strategies to users to reduce the risk of seizures and their associated complications.

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Source
https://linkinghub.elsevier.com/retrieve/pii/S0161813X193003
Publisher Site
http://dx.doi.org/10.1016/j.neuro.2019.04.003DOI Listing
April 2019
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