Elsevier

Epilepsy Research

Volume 165, September 2020, 106399
Epilepsy Research

Assessing the risk of seizures with chloroquine or hydroxychloroquine therapy for COVID-19 in persons with epilepsy

https://doi.org/10.1016/j.eplepsyres.2020.106399Get rights and content

Highlights

  • The evidence suggesting increased seizure risk with chloroquine or hydroxychloroquine is limited to case studies.

  • There is no class I evidence to suggest chloroquine or hydroxychloroquine can increase seizure risk.

Abstract

Background

The goal of this systematic review is to assess the published literature for seizure risk with chloroquine or hydroxychloroquine therapy in persons with and without epilepsy. With the COVID-19 pandemic, there is a desperate need for treatment against the SARS CoV-2 virus. Chloroquine or hydroxychloroquine is one proposed medication that has received substantial public attention. However, the package insert states that these medications may provoke seizures in patients with epilepsy, and this has resulted in increased questions and anxiety in the epilepsy community.

Methods

PubMed (1970 to March 27, 2020) and the Embase (1970 to March 27, 2020) were searched with the terms chloroquine or hydroxychloroquine and seizure or epilepsy, convulsions, or status epilepticus. Selected studies were reviewed, and the adverse drug reaction was classified.

Results

Only eleven out of 31 studies were deemed eligible for systematic analysis. For chloroquine, eligible studies were- one prospective study(n = 109), two case series(n = 6), and six case reports. The dose of chloroquine ranged between 100−500 mg/day, except in one patient with a seizure, who was after taking 1000 mg. For hydroxychloroquine, there was one prospective observational study(n = 631) and one case report. The clinical trials failed to find any significant relation between seizures and chloroquine or hydroxychloroquine.

Conclusion

Although the package insert describes an increased risk of seizure, the systematic review highlights that such a statement is not supported by class I evidence. Clinicians, therefore, need to understand that data regarding this specific topic is limited to case series and case reports. There is no substantial evidence to suggest that these medications can increase seizure risk.

Keywords

Chloroquine
Hydroxychloroquine
COVID-19
Epilepsy

Cited by (0)

View Abstract