Drug Induced Seizures
BP Issue 11
Check out BP's Overdose pages for more info on seizures - in particular, ones that follow or are connected with an overdose.
Many BP readers will have already witnessed the distressing sight of someone having a seizure, or you may have even experienced one yourself. Drug induced seizures can leave you confused as to what to do next...
It can be frightening to watch, exhausting to go through and unfortunately, people can often make the situation worse by not knowing how to deal with seizures properly, leaving everyone concerned thoroughly freaked out. Most people associate seizures with having epilepsy and while it is certainly true to say that seizures (there are over 40 different types) are a symptom of having epilepsy, you don't have to have epilepsy, to have a seizure. Anyone who has seen someone have a cocaine or alcohol induced seizure can attest to that.
Seizures and drug use
For those of us who use drugs, seizures can occur for a few reasons. Sometimes they happen just before or as someone is overdosing, (decrease in oxygen levels), or it may happen whilst experiencing withdrawals from a drug/s (i.e benzodiazepines, alcohol) or, seizures can occur when our systems have reached a point of toxicity or overload (such as with too many pills, mushrooms, antidepressants etc). They can also be a (rather intense) way of telling us that we have been pushing our bodies too hard for too long (e.g cocaine / stimulant related).
Everyone however, has what is called a 'seizure threshold', a certain sensitivity to seizures which means that anyone can experience one given the right conditions - such as excess use of alcohol, drug withdrawal etc. With 1 in 20 people having experienced a seizure at some stage in their lives, amongst drug users that rate increases dramatically, so it’s important that we learn something about seizures, their 'triggers' as well as their treatment.It can be all too common to put the odd re-occurring seizure down to 'just the drugs I'm taking' or find that any medical investigations have not been followed up due to the pressures of everyday life and the difficulty embarking on consistent/stable medical care. But it's important to remember that seizures can be very serious, they can even be fatal, they are hard work for the body and the brain and, depending on where you arewhen you have your seizure, you can be hurt or left in dangerous or vulnerable situations. If you are affected by seizures, if you have had more than 2 or if your seizures occur regularly, it is essential you seek medical advice - at least to rule out any underlying causes such as infection, viruses, tumors etc.
How seizures affect the brain.
Seizures can occur in specific parts of the brain, or can be more generalised. How your seizure affects you (speech, movement, memory etc) helps point to where it’s occurring in the brain.
It is helpful to understand how seizures work in the brain and to do this one needs to have a little knowledge of your grey matter - a bit about how the brain is constructed. Normal brain function is made possible by millions of tiny electrical charges passing information between nerve cells in the brain to all parts of the body. Normally, nerve transmission in the brain occurs in an orderly way, allowing a smooth flow of electrical activity. A seizure occurs when these neurons generate uncoordinated electrical discharges that spread throughout the brain. Normal activity gets interrupted by brain cells 'firing' much faster than usual. These 'storms' (intermittent bursts of activity) affect the delicate systems in the brain and can cause disruption, leading to a seizure. Interestingly, certain areas of the brain are much more likely than others to be the source of a seizure. These include the motor cortex (responsible for the initiation of body movement) and the temporal lobes (including a special deep area called the hippocampus, which is involved in memory). This is also why memory and muscle coordination are affected during a seizure. The reason for this may be that the nerve cells in these areas are particularly sensitive to situations that can provoke abnormal electrical transmission such as; sensitivity to a decrease in oxygen levels (such as when you have a large 'hit' of a drug), metabolic changes and infection, any of which may cause a seizure. There are many unanswered questions about why seizures begin; why trauma (such as head injury) can produce seizures years after the event, how genetic factors influence seizures, what factors make brain cells susceptible and why some people get them from some drugs, while others don't. Whatever the cause, it’s important to get it investigated.
Know Your 'Triggers'
After having a seizure, your sensitivity to them will have increased. Some people find that seizures will come in 'pairs', another occurring a week or month after the last. Many people, after many fits, often come to know when a seizure is about to happen, some sense a strange smell or taste, or some feel an 'aura' or a wave of anxiety or fear surround them. It is usually very subtle although nowadays there are even dogs that are specially trained to sense when their owner is about to have a seizure and will encourage the person through signals or crying, to sit down or get help, helpful for those with more uncontrollable seizures or epilepsy. However, for a seizure that is brought on by drugs, you probably won't get any warnings yet you may be able to understand what makes you more vulnerable to having one - what drugs tend to 'push you over the edge'. Whether it is more likely to occur when you've drunk a lot of alcohol or been banging up coke solid for 2 days with no sleep.
At BP, a few of us experience seizures through long term drug related issues, and although it has taken some years to begin to understand how our seizures affect us as individuals, we were able to feel more confident about the situation by learning about our ‘triggers’. Such as writing down in a diary, the date the seizure occurred, what was going on in the days and weeks beforehand, which can lead to a reasonable understanding of what makes one more vulnerable and then, being able to take extra care i.e trying not to be alone when you have a ‘hit’ (good practice anyway), not getting up straight away - sitting down for 15 minutes afterwards, getting enough sleep and food before you take drugs and listening to your body - know when you’ve had enough.
Extra stress, fatigue, lack of sleep, too much alcohol or drugs, vitamin or mineral deficiency (such as anemia), menstrual changes and various other factors can all increase some peoples' tendency to have seizures. Most people can learn for themselves what are their `triggers' and take steps to ensure they get enough sleep, eat well, get time to relax, and become more cautious around their drug intake.
Treatments
Although epilepsy drugs have generally been difficult to take due to their side effects, they have recently been a whole new group of epilepsy drugs that are more easily tolerated, and with less debilitating side effects and many people are able to discontinue treatment after a few years on medication. People can go into 'remission' with no seizures occurring for many years and others will find their seizures stop or lessen when certain factors in their life change, such as their drug use, (including alcohol) stress levels, food intake, sleeping patterns etc.
Some anti-epileptic drugs (AEDs) are enzyme-inducing which means they speed up the way the liver breaks down some drugs. This is likely to reduce a drugs effectiveness, such as the pill or possibly methadone. Be sure to talk to your doctor or the Epilepsy Foundation (see refs), or try some of the many website forums and talk to others.
When Someone Has a Seizure...
1) Don’t panic, it’s important to stay calm for everyone’s sake.
2) Prevent injury - use common sense by making sure there’s is nothing within reach that could harm the person.
3) Make the person as comfy as possible, keep others quiet and away, not crowding the person. It’s important to keep the surroundings calm as a person can be very confused and/or scared after a seizure. A friendly face and soothing tones will be helpful.
4) Pay attention to the length of the seizure.
5) Do not hold the person down. There are various types of seizures, some have more movement than others, it’s really not necessary to restrain someone and ok to consider your own safety to.
6) DO NOT put anything in the person’s mouth. Contrary to popular belief, a person is incapable of swallowing their tongue while having a seizure and not only that, you could break teeth or get bitten yourself.
7) Once they stop fitting, a person will be confused and probably not fully conscious for up to 30 minutes. Because there can be small risk of vomiting after a seizure, the person should be placed on their side, preferably in the recovery position. The head should be turned to the side so any vomit can drain out of the mouth without being inhaled. (Bend the left arm and leg up and roll them over onto their right side, with their right arm supporting their head (see pics at this BP link).excellent websites: http://www.esgs.org.uk/faq.asp
http://www.cbel.com/epilepsy/Check out BP's Overdose pages for more info on seizures - in particular, ones that follow or are connected with an overdose.