Emerging Trends in Drug-Induced Seizures: A Pilot Study

Background: Seizures, indicative of uncontrolled and abnormal electrical activity in the brain, constitute a significant concern in emergency medicine. Objectives: This pilot study, conducted in two toxicology centers in Yazd, Iran, aimed to enhance our understanding of drug-induced seizures (DIS). Methods: This five-year cross-sectional study analyzed 205 cases in two toxicology centers in Yazd, Iran. The investigation focused on demographic distribution, causative agents, and clinical outcomes. Data entered into SPSS version 26 and analyzed. p 0.05 was assumed significant. Results: Tramadol emerged as the predominant cause of DIS (74.15%), followed by benzodiazepine withdrawal (7.8%), organophosphorus toxins (3.41%), and methadone (3.41%). Tramadol ingestion was correlated with status epilepticus (Odds ratio (OR) = 4.166, 95% CI = 1.73-10.01), ICU admission (OR=3.394, CI = 1.623-7.1), and intubation (OR=0.057, CI = 0.012-0.272) P 0.05), but no significant correlation was observed between tramadol ingestion and overall outcome (P 0.05).  A significant correlation was found between ICU admission and age (P=0.04). Additionally, a notable correlation was seen between drug categories with outcome, status epilepticus, ICU admission, and intubation (P 0.05). Among five deaths, 2 (40%) were related to tramadol, 2 (40%) to organophosphorus compounds, and 1 (20%) to methadone. Conclusion: Drug-induced seizures present critical challenges in emergency settings. Moreover, the widespread use of tramadol and a recent trend in its abuse have contributed to drug-induced seizures.  Organophosphorus toxins, though uncommon, led to severe complications and high mortality. Further research is essential to develop predictive models and refine clinical approaches in managing diverse drug-induced seizure scenarios.