levetiracetam and Nausea

Misuse of various new psychotropic substances such as ibogaine is increasing rapidly. Knowledge of their negative side effects is sparse.. We present a case of intoxication with the herbal substance ibogaine in a 22-year-old white man. After taking a cumulative dose of 38 g (taken in two doses), he developed visual memories, nausea and vomiting. He developed a generalized tonic-clonic seizure with additional grand mal seizures. He was treated with midazolam and levetiracetam. Extended drug screenings and computed tomography and magnetic resonance imaging findings were all negative.. Knowledge of the side effects of ibogaine has mainly come from reports of cardiovascular complications; seizures are rarely mentioned and experimental findings are inconsistent. It seems that ibogaine acts like a proconvulsive drug at high doses.

Topics: Adult; Anticonvulsants; Epilepsy, Tonic-Clonic; Hallucinogens; Humans; Hypnotics and Sedatives; Ibogaine; Levetiracetam; Magnetic Resonance Imaging; Male; Midazolam; Nausea; Piracetam; Treatment Outcome; Vomiting

Anticonvulsant hypersensitivity syndrome (AHS) is a rare, potentially life-threatening drug reaction which usually occurs after exposure to aromatic antiepileptics. AHS secondary to non-aromatic antiepileptics is even more rare and there are only few case reports of AHS presenting as aseptic meningitis. We present the case of a 48-year-old patient who presented with meningism within 3 weeks of adding lamotrigine for control of her juvenile myoclonic epilepsy. When lamotrigine was restarted 2 weeks later she developed similar but more severe symptoms which resolved on stopping lamotrigine. Our patient was subsequently rendered seizure free on levetiracetam which has not so far been linked with this syndrome. It is important to be aware of this life-threatening complication associated with the use of antiepileptics.

Topics: Anti-Bacterial Agents; Anticonvulsants; Drug Administration Schedule; Drug-Related Side Effects and Adverse Reactions; Female; Fever; Headache; Humans; Lamotrigine; Levetiracetam; Meninges; Meningitis, Aseptic; Middle Aged; Myoclonic Epilepsy, Juvenile; Nausea; Piracetam; Steroids; Triazines

Topics: Age Factors; Anticonvulsants; Antiemetics; Antineoplastic Agents; Brain Neoplasms; Glioblastoma; Humans; Levetiracetam; Logistic Models; Nausea; Piracetam; Retrospective Studies; Vomiting