The effects and risks of so-called recreational drugs vary greatly. Whether they directly influence the occurrence of seizures or interact with prescribed seizure medicines will differ from drug to drug and from person to person.

Cocaine

All forms of cocaine consumption can cause seizures within seconds, minutes, or hours after its use. Seizures caused by cocaine are uniquely dangerous and may be associated with heart attacks, interruption of the heart's normal rhythm (cardiac arrhythmia), and death. They can even occur in someone who has never had a seizure before. If you have epilepsy, you definitely should avoid cocaine.

Amphetamines and other stimulants

Amphetamines are brain stimulants. When used under a doctor's supervision, amphetamines or other stimulants do not appear to increase the likelihood of seizures in people with epilepsy. If you abuse amphetamines or related drugs like "Ecstasy" (MDMA), however, you can experience sleep deprivation, confusion, or major psychiatric disorders. With these effects, you are very likely to forget to take your seizure medicine and thus are much more likely to have seizures. Some researchers have also found long-lasting damage to the brain from the use of some types of stimulants. Very high doses of amphetamines can cause severe tonic-clonic seizures, heart attacks, and death.

Marijuana

Studies in animals have suggested that THC, the active ingredient in marijuana, and cannabidiol, another substance in marijuana, have some antiseizure properties as well as seizure-provoking effects. Because it causes a variety of adverse effects, marijuana is not recommended for the treatment of epilepsy. Furthermore, even if marijuana or one of its components had some antiepileptic effects in humans, abrupt withdrawal of the substance after recreational use may increase the likelihood of seizures.

Heroin

Heroin and related narcotics—drugs derived from opium, such as OxyContin (oxycodone), and manufactured drugs that are chemically similar to opium—do not directly affect the likelihood of seizures in people with epilepsy. People who use these drugs often forget to take their prescribed seizure medicines, however. Taking large amounts of narcotics can cause serious oxygen deprivation to the brain, which can lead to seizures.

Nicotine and caffeine

There is no evidence that using these two popular legal drugs in usual amounts affects seizure control for most people with epilepsy. Occasionally there are stories of susceptible people who experience seizures, especially if they use large amounts. It may be difficult to tell how much caffeine you are consuming, since many different beverages, foods, and medications include it.

Cigarette smoking presents a more likely danger than the effects of nicotine for people with seizures: the loss of consciousness or control of movement can cause you to drop a lighted cigarette and start a fire.

Look for more information in the Drug Facts section of the Office of National Drug Control Policy website, or at: PubMed, a service of the National Library of Medicine.

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed:12/15/06