Epilepsy is a common neurological disorder that requires standardized and individualized antiepileptic drug therapy; irregular drug therapy will greatly increase the frequency of seizures. But did you know? In addition to the irrational application of antiepileptic drugs can induce seizures, there are many drugs that can induce seizures, and the range and number of drugs involved are wide, mainly including antipsychotic drugs, antibiotics, anesthetic drugs, antineoplastic drugs, corticosteroids, etc. In addition to this there are some drugs that have been scattered in clinical reports. The incidence of clinically reported seizure-inducing drugs is highest for antipsychotic drugs, followed by antibiotics; in addition, such drug-induced seizures can occur in both epileptic patients and normal individuals. The following author briefly describes these drugs in the hope of drawing clinical attention to them. Antipsychotic drugs The incidence of seizure-inducing antipsychotic drugs is higher with clozapine, chlorpromazine, promethazine, and haloperidol. Antibacterial drugs Antibacterial drugs that induce seizures are mainly penicillins, cephalosporins and quinolones, among which penicillins have the highest incidence. Penicillin-induced seizures are related to the dose and route of administration. Large doses of intravenous penicillin can easily cause seizures, and normal doses given in patients with severe renal insufficiency can also induce seizures. High dose application of penicillin, renal insufficiency, and history of epilepsy are important risk factors for seizure induction. The incidence of seizures induced by cephalosporins is higher in patients with renal insufficiency, which may be due to the slowed excretion of the drug through the kidneys and the accumulation of the drug in the body, which triggers seizures through the blood-brain barrier. Therefore, they should be used with caution or in small doses in patients with renal insufficiency. Among the quinolones, ciprofloxacin, levofloxacin, and norfloxacin-induced seizures are more common, and quinolone-induced seizures are dose-dependent and mostly reversible. Patients with epilepsy and central nervous system diseases such as cerebral infarction are more likely to have adverse reactions to quinolones, so they should be used with caution; elderly people and patients with renal insufficiency should also be used with caution based on adequate assessment of their liver and kidney functions; in addition, quinolones are likely to induce seizures when used in combination with theophylline drugs and NSAIDs, so combined use should be avoided. The mechanism of seizures caused by isoniazid is probably due to vitamin B6 deficiency and reduced glutamic acid decarboxylase activity caused by the use of isoniazid, which in turn leads to impaired synthesis of γ-aminobutyric acid. Narcotic drugs Narcotic drug-induced seizures are more commonly reported clinically with commonly used doses of ketamine and occur mainly in pediatric patients, probably because the central nervous system is relatively underdeveloped in children, and ketamine can directly or indirectly excite various parts of the central nervous system. Corticosteroids Prednisone and dexamethasone can induce seizures when used intravenously in large doses for a long time. The mechanism may be that the glucocorticoids enter the cerebrospinal fluid, making the brain more excitable and certain neurons suddenly over-repeat. Brain neurotrophic drugs Piracetam, cerebroprotein hydrolysate, cytarabine, cerebrosides and other brain neurotrophic drugs are commonly used in neurology, which have the effect of nourishing nerve cells and improving brain function. In addition to the drugs described above, there are many other drugs that can cause seizures, such as: antiarrhythmic drugs verapamil and mexiletine commonly used in cardiology, aminophylline commonly used in respiratory medicine, cimetidine commonly used in gastroenterology, and antineoplastic drugs such as vincristine, methotrexate and paclitaxel can induce the occurrence of seizures. In conclusion As there are many drugs that can induce epilepsy in the clinic, it is difficult to remember all of them, so we must develop the habit of checking the instructions diligently when using them in the clinic. In addition, the patient’s liver and kidney function should be taken into consideration to avoid abnormally high blood levels that could trigger seizures. In addition, the clinical standardization and rationalization of medication, combined medication, pay attention to drug interactions, close observation during the use of drugs, and timely treatment of the situation.