Exacerbation of seizures in medial temporal lobe epilepsy due to an α1-adrenergic antagonist

Abstract

Purpose: We describe the first reported case of a proconvulsant effect of an α1-adrenergic antagonist in humans. Methods: A patient with medial temporal lobe seizures (MTLE) had increased seizure frequency after treatment with tamsulosin, an α1-adrenergic antagonist. Results: Experimental evidence suggests that noradrenaline, which has inhibitory effects on the excitatory synaptic response, can act as a powerful anticonvulsant. Mostly, α2-adrenoreceptors, but also α1-adrenoreceptors, have been implicated in this effect by different experimental models. Clinical reports of a proconvulsant or anticonvulsant effect of drugs that act through the adrenergic pathway are scarce. Conclusions: This is the first report of a proconvulsant effect by an α1-adrenergic antagonist in humans and suggests that α1-adrenoreceptors may be involved in modulating noradrenergic activity in the limbic region. © 2006 International League Against Epilepsy.