A 41-year-old woman with a history of polysubstance use experiences a seizure. Which drug is most likely to precipitate this seizure in the withdrawal/early recovery period?

A 41-year-old woman with a history of polysubstance use experiences a seizure. Which drug is most likely to precipitate this seizure in the withdrawal/early recovery period?

• A. Heroin
• B. Suboxone
• C. Klonopin
• D. Cocaine

Answer: (C)

Seizures in withdrawal are most characteristic of benzodiazepine withdrawal. When someone has been using benzodiazepines chronically, the body becomes dependent. Abruptly stopping or rapidly tapering removes the GABA-ergic inhibition that these drugs provide, leading to neuronal hyperexcitability and a higher risk of seizures during withdrawal or early recovery. Clonazepam is a benzodiazepine, so its withdrawal would be most likely to precipitate a seizure in the withdrawal/early recovery period. By contrast, opioid withdrawals (heroin or buprenorphine/naloxone) and stimulant withdrawals (cocaine) do not typically present with seizures, though they cause other symptoms.

Seizures in withdrawal are most characteristic of benzodiazepine withdrawal. When someone has been using benzodiazepines chronically, the body becomes dependent. Abruptly stopping or rapidly tapering removes the GABA-ergic inhibition that these drugs provide, leading to neuronal hyperexcitability and a higher risk of seizures during withdrawal or early recovery. Clonazepam is a benzodiazepine, so its withdrawal would be most likely to precipitate a seizure in the withdrawal/early recovery period. By contrast, opioid withdrawals (heroin or buprenorphine/naloxone) and stimulant withdrawals (cocaine) do not typically present with seizures, though they cause other symptoms.