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Abstract
The widespread availability and use of herbal medicines raise the potential for adverse
effects in the epilepsy population. Herbal sedatives (kava, valerian, chamomile, passionflower)
may potentiate the effects of antiepileptic medications, increasing their sedative
and cognitive effects. Despite some antiseizure effects in animal models, they should
not be used in place of standard seizure medications because efficacy has not been
established. Anecdotal, uncontrolled observations suggest that herbal stimulants containing
ephedrine (ephedra or ma huang) and caffeine (cocoa, coffee, tea, maté, guarana, cola
or kola) can exacerbate seizures in people with epilepsy, especially when taken in
combination. Ginkgo and ginseng may also exacerbate seizures although the evidence
for this is similarly anecdotal and uncertain. St. John's wort has the potential to
alter medication pharmacokinetics and the seizure threshold. The essential oils of
many plants contain epileptogenic compounds. There is mixed evidence for evening primrose
and borage lowering the seizure threshold. Education of both health care providers
and patients is the best way to avoid unintentional and unnecessary adverse reactions
to herbal medicines.
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Dietary Supplement Health and Education Act of 1994, 1994; Pub L No. 103–417.
Article info
Publication history
Accepted:
September 25,
2001
Received in revised form:
September 13,
2001
Received:
May 24,
2001
Footnotes
☆To whom correspondence should be addressed. E-mail: [email protected]
Identification
Copyright
© 2001 Elsevier Science (USA). Published by Elsevier Inc. All rights reserved.
