Exacerbation of Seizures in Medial Temporal Lobe Epilepsy Due to an α1‐Adrenergic Antagonist

Abstract

We describe the first reported case of a proconvulsant effect of an alpha(1)-adrenergic antagonist in humans. A patient with medial temporal lobe seizures (MTLE) had increased seizure frequency after treatment with tamsulosin, an alpha(1)-adrenergic antagonist. Experimental evidence suggests that noradrenaline, which has inhibitory effects on the excitatory synaptic response, can act as a powerful anticonvulsant. Mostly, alpha(2)-adrenoreceptors, but also alpha(1)-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. This is the first report of a proconvulsant effect by an alpha(1)-adrenergic antagonist in humans and suggests that alpha(1)-adrenoreceptors may be involved in modulating noradrenergic activity in the limbic region.