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Anticonvulsants in Cocaine Overdoses

hussness

Bluelighter
Joined
Mar 12, 2005
Messages
513
Location
Western U.S.
I recently read in the Merck Manual for Healthcare Professionals that, "anticonvulsants do not prevent seizures due to cocaine overdose". I was under the impression that the main reason why barbiturates or benzos are administered in cases of cocaine overdoses is to combat possible seizures or status epilepticus. Does anyone have any information on why anticonvulsants would be ineffective in this case? I tend to trust Merck, but if they aren't wrong about this what would be the course of treatment for this situation?
 
I know this isn't too relelvant but...

Fin-de-siecle wisdom from the last century claims that cocaine and opium are antidotes for each other. I don't remember where I saw the reference but I'll give it to you when I find it. I do know that coca has helped me personally overcome an opiate near-OD. Thankfully, I never had the misfortune of experiencing the other so I cannot relate...

This is weird eh? Perhaps it sheds light on this.
 
Well they do have some opposing effects on the autonomic nervous system, but I think "antidote" would be a bit of a stretch.
 
the convulsive effects of cocaine have supposedly been linked to sigma receptor activity but also to NMDA:
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=1847729&dopt=Citation
Life Sci. 1991;48(11):PL51-6.

Modulators of N-methyl-D-aspartate protect against diazepam- or phenobarbital-resistant cocaine convulsions.

Witkin JM, Tortella FC.

Drug Development Group, Psychobiology Laboratory, NIDA Addiction Research Center, Baltimore, MD 21224.

The anticonvulsants diazepam (1-10 mg/kg) and phenobarbital (30-100 mg/kg) protected against lethality without altering clonic convulsions induced by 75 mg/kg cocaine (CD100) in male Swiss Webster mice. In contrast, the non-competitive N-methyl-D-aspartate (NMDA) antagonists, MK-801 (dizocilpine) and phencyclidine, produced dose-dependent protection against cocaine convulsions. The competitive NMDA antagonists, CPP and NPC 12626, were also anti-convulsant, without producing the behavioral disturbances associated with non-competitive antagonists. Diazepam and phenobarbital protected against convulsions induced by 60 mg/kg cocaine (90% convulsions alone). Compounds that act at the strychnine-insensitive glycine receptor of the NMDA receptor complex, ACPC and 7-chlorokynurinic acid, also protected against convulsions induced by 60 mg/kg cocaine. In contrast, the non-opioid antitussive anticonvulsants (dextromethorphan, caramiphen, and carbetapentane) were not active against either dose of cocaine. The efficacy of compounds as antagonists of the convulsant effects of cocaine and NMDA appear related. These results suggest a potential role for the NMDA receptor complex in the convulsant actions of cocaine and new molecular targets for drug discovery in treating cocaine toxicity.
 
Score! Ketamine gets another +1 as a miracle drug :D

Perhaps that explains why I didn't have a siezure that time I went out of control IVing bellringers. At the time I had Ketamine in my system.
 
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