Get access

Are certain diuretics also anticonvulsants?

Authors

  • Dale C. Hesdorffer PhD,

    Corresponding author
    1. G. H. Sergievsky Center, New York, NY
    2. Mailman School of Public Health, New York, NY
    3. Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, MN
    • Gertrude H. Sergievsky Center, Columbia University, 630 West 168th Street, New York, NY 10032
    Search for more papers by this author
  • James P. Stables MSA,

    1. Epilepsy Branch, Preclinical Pharmacology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD
    Search for more papers by this author
  • W. Allen Hauser MD,

    1. G. H. Sergievsky Center, New York, NY
    2. Mailman School of Public Health, New York, NY
    3. Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, MN
    4. Department of Neurology, Columbia University, New York, NY
    Search for more papers by this author
  • John F. Annegers PhD,

    1. Division of Epidemiology, University of Texas, Houston, TX
    Search for more papers by this author
    • Deceased.

  • Gregory Cascino MD

    1. Neurology, Mayo Clinic and Mayo Foundation, Rochester, MN
    Search for more papers by this author

Abstract

A history of diuretic use has been shown to be protective for first unprovoked seizure in adult patients. Recent animal studies suggest that certain diuretics have anticonvulsant activity. We evaluated the potential for the anticonvulsant activity of current diuretic use in a population-based, case–control study in older adults. We also tested chlorthiazide and furosemide for seizure protection in animal models of epilepsy. Concurrent medical prescription of any diuretic was protective for the development of epilepsy [odds ratio (OR) = 0.62, 95% confidence interval (CI) = 0.39–0.99]. A protective effect for current thiazide use was observed (OR = 0.53, CI = 0.31–0.90), and a protective effect for furosemide was suggested (OR = 0.44, CI = 0.1–1.9). In mice, both chlorthiazide and furosemide suppressed the occurrence of maximal electroshock-induced seizures in a dose-dependent manner. Chlorthiazide's toxic dose for 50% of animals tested (TD50) could not be achieved even with dosing as high as 1,500 mg/kg; for furosemide, TD50 was 549 mg/kg. Results were similar in rats. Furosemide and chlorthiazide are protective for unprovoked seizures in an epidemiological study and in animal models. Given the potential therapeutic value for seizure control, low toxicity, and low cost, therapeutic efficacy should be explored in clinical studies.

Get access to the full text of this article

Ancillary