P-50 * THE PREVALENCE OF SEIZURES DURING WITHDRAWAL FROM ALCOHOL, BENZODIAZEPINES AND OPIATES IN MEDICALLY MONITORED DETOXIFICATION CENTER

Abstract

Generalized tonic-clonic seizures are the common severe complication of drug withdrawal. Efforts to prevent occurrence of seizures is an important factor in improvement of safety and quality of patient care. Medically monitored detoxification centers admit patients with known history of withdrawal seizures as well as history of seizure disorders for detoxification from alcohol benzodiazepines and opioids. Over last two years 12356 patients were admitted for inpatient detoxification, 260 patients had known history of seizures due to variety of etiologies. Patients underwent detoxification using chlordiazepoxide, phenobarbital and methadone. During last 2 years 38 patients developed seizures during detoxification. All occurrences were reviewed on the monthly basis as a part of quality of patient care monitoring. Majority of seizures are early onset events and occur within 48 hours from time of admission due to alcohol, and combined alcohol/ benzodiazepine withdrawal. Minority of seizures were related to benzodiazepine/opioid withdrawal, and use of medication lowering the seizure threshold like bupropion and antipsychotics, and were of late onset. In conclusion majority of tonic-clonic seizures in patients undergoing detoxification in medically monitored are an early onset seizures occurring in patients withdrawing from alcohol or alcohol/benzodiazepine combination. Detoxification using log acting benzodiazepines or phenobarbital is a safe therapy for patients with prior history of seizures. Avoidance of medication reducing seizure threshold may further reduce incidence of seizures.