Odd OxTox Question

HullBlister · Sep 1, 2008

Would anti-seizure medication like clonazepam (or a similar benzo) actually raise the OxTox threshold?

I am not planing on taking any to try it out, nor do I think it would be wise for anyone to try this. It was just something I was thinking about.

Thanks,
Blister

bamamedic · Sep 1, 2008

I got this off the DAN website:

Benzodiazepines
Medications in this group used to treat anxiety include: Alprazolam / Xanax, Chlordiazepoxide / Librium, Clonazepam / Klonopin, Clorazepate / Tranxene, Diazepam / Valium, Halazepam / Paxipam, Lorazepam / Ativan, Oxazepam / Serax, Prazepam / Centrax.
Side effects adverse to diving:

Drowsiness: A common side effect. Be sure you know how you react to this medicine before driving or using dangerous machinery.
Dizziness: Be careful about standing up quickly, going up and down stairs and driving.
Difficulty learning: An unusual side effect, it tends to go away quickly with continued use.

DAN Divers Alert Network : Psychological Issues in Diving II - Anxiety, Phobias in Diving

They didn't mention anything about lowering a patient's seizure threshold, but of course, you'd want to check with a physician or pharmacist...

Someone once told me that if you were already prone to seizures, then your "seizure threshold" is much less than someone who has never had a seizure. Going by that logic, if have a history of seizures, and then expose yourself to something which can interfere with CNS function (like a high PO2), then, theoretically, you'd sustain a greater chance of having a seizure because your body's "seizure threshold" is lower than a normal person's.

Hope this helps...

Gene_Hobbs · Sep 1, 2008

Donald showed that day to day variation in CNS toxicity onset was wide. This does make this type of research difficult. There has been some work done on antiepileptic and vasooactive drugs that you might be interested in. I would start with the paper below for a summary.

Bitterman. CNS oxygen toxicity. Undersea Hyperb Med. 2004 Spring;31(1):63-72.
RRR ID: 3991

Then do searches in our database and pubmed for more work by Bitterman and maybe Piantadosi.

RRR Bitterman
pubmed Bitterman

RRR Piantadosi
pubmed Piantadosi

HullBlister · Sep 1, 2008

Thanks for the responses.

Blister

Dive-aholic · Sep 2, 2008

I wouldn't take a benzo before diving. Benzos are used to treat seizures by slowing down the central nervous system while we load up the body with other drugs that control seizures better. They are used to calm people down and often make them sleepy. They would not be a good class of drugs to take before dives.

HullBlister · Sep 2, 2008

Dive-aholic:
I wouldn't take a benzo before diving. Benzos are used to treat seizures by slowing down the central nervous system while we load up the body with other drugs that control seizures better. They are used to calm people down and often make them sleepy. They would not be a good class of drugs to take before dives.

Agreed.

I was just thinking that it is theoretically possible to raise the OxTox threshold by using some sort of anti-seizure drug.

That said, I do not think it would be a good idea at all to do.

Blister

TSandM · Sep 2, 2008

It would appear, from the reference Gene provided, that the anti-epileptic medications they've looked at have increased the time to symptoms at a given ppO2, which doesn't surprise me. Seizures involve increased irritability of neurons, and to generalize, the electrical activity has to spread, so anything that stabilizes membranes is something one would expect to see decrease the likelihood of seizures. The problem, as Dive-aholic has said, is that all of those drugs have sedating side effects, so their use is problematic for divers (and drivers, and machinery operators . . . )

What surprised me in the article was that caffeine had a protective effect. I've now got a good excuse for having a latte before getting in the water!

Ben_Ayers · Sep 2, 2008

Thanks for the informative article Gene. I too was surprised with the mention of caffeine causing an increase in the latency period. I was also very surprised by the mention of light and food/water deprivation also being potentially protective. It was also enlightening to see the daily individual variability (approx. 20-90minutes) before onset of symptoms.
If I ever dive without my morning java, on a full stomach, and in a dark quarry, perhaps I'll use a lower limiting Po2 than usual. It certainly sounds like much more research is needed.

Ben

HullBlister · Sep 2, 2008

To take this one step further....

I was once told that the type of seizure experienced by someone who is withdrawing from drugs (specifically benzos) or alcohol is a "different type" of seizure (what that means exactly I can't detail) than say one caused by a seizure disorder.

Could I then extrapolate that an OxTox seizure is also of a "different type"? As in the mechanism is not related to the two examples above?

Sorry for being vague, but I am not in the medical field.

Thanks,
Blister

DandyDon · Sep 2, 2008

HullBlister:
Agreed.

I was just thinking that it is theoretically possible to raise the OxTox threshold by using some sort of anti-seizure drug.

That said, I do not think it would be a good idea at all to do.

Blister

Do you know someone taking anti-seizure meds and diving? I do. Didn't know until he had an incident on the dock after diving in Coz on a group trip; seems that he hadn't been taking his meds. He was going to sell all of his gear and he did sit out the diving that week, you'd think that they incident would tell him that diving and his seizures shouldn't mix, but he continued. All I could do after conveying my opinions was refuse to dive with him, but he showed up on a Flower Gardens liveaboard last summer with the old group - the only one not diving Nitrox so they ran him thru a Discover Nitrox so it'd be 100%. I certainly wasn't happy but I just kept quiet and hoped...

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