Meperidine and Convulsion: is the FAERS signal real?
Meperidine ↔ Convulsion
Meperidine is an opioid analgesic; its metabolite normeperidine accumulates, especially in renal impairment or with repeated dosing, and is a central nervous system excitant that causes tremor, myoclonus, and seizures (77 co-reports, PRR 3.0). This distinctive neurotoxicity is why meperidine is avoided in renal failure and in patients taking MAOIs.
Regulatory basis: meperidine prescribing information — normeperidine neurotoxicity/seizures; contraindicated with MAOIs.
| Bradford Hill viewpoint | Status | Note |
|---|---|---|
| Temporality (necessary) | met | Seizures with drug accumulation |
| Strength | met | PRR 3.0, modest |
| Consistency | met | Reproduced across case series |
| Specificity | met | Fairly specific to meperidine |
| Biological gradient | met | Worse with higher doses or renal impairment |
| Plausibility | met | Normeperidine CNS excitation |
| Coherence | met | Fits the pharmacology |
| Experiment | n/a | Not a trial endpoint |
| Analogy | met | Analogous to other metabolite-driven neurotoxicity |
This table is this page's own qualitative read of the literature cited above, not an automated or citation-gated assessment — see the note at the bottom of this page.
✓ Trial evidence found — E7 TCR T Cells for Human Papillomavirus-Associated Cancers (NCT02858310)
| Adverse event | Phase I:Dose Escalation Cohort; Arm 1:Phase I:DoseLevel 1: 1 x 10^9 E7 T-Cell Receptor (TCR) Cells (n=3) · Phase I: Dose Escalation Cohort; Arm 1: Phase I; Dose Level 2: 1 x 10^10 E7 T-Cell Receptor Cells (n=3) · Phase I: Dose Escalation Cohort; Arm 1: Phase I; Dose Level 3: 1 x 10^11 E7 Cells (n=6) · Phase II Cohort; Arm 2: Phase II: 1 x 10^11 E7 Cells (n=18) | |||
|---|---|---|---|---|
| Seizure | 0/3 | 0/3 | 0/6 | 1/18 |
Post-marketing signal terms appear in this trial's posted adverse-event tables; per-arm counts shown as affected/at-risk. View on ClinicalTrials.gov →