Thursday, April 4, 2019

FDA Warns Some E-Cigarette Users Having Seizures, Particularly Youth


Psychiatrists may wish to ask patients about vaping, particularly adolescents and young adults, in response to a special announcement released yesterday by the Food and Drug Administration (FDA) regarding the incidence of seizures following use of e-cigarettes.

An FDA review of voluntary adverse event reports for e-cigarettes identified 35 cases of seizures following use of these products between 2010 and early 2019. Seizures or convulsions are known potential side effects of nicotine toxicity and have been reported following intentional or accidental swallowing of e-liquid. Some e-cigarettes deliver high concentrations of nicotine, with some containing as much nicotine as an entire pack of regular cigarettes.

“While 35 cases may not seem like much compared to the total number of people using e-cigarettes, we are nonetheless concerned by these reported cases,” wrote outgoing FDA Commissioner Scott Gottlieb, M.D., and Principal Deputy Commissioner Amy Abernethy, M.D., Ph.D., in a joint statement.

Gottlieb and Abernethy asserted that e-cigarettes could “serve as an off-ramp for currently addicted adult smokers to completely switch to a potentially less harmful form of nicotine delivery.” At the same time, however, the pair acknowledged “tremendous concern for epidemic-level rises of youth e-cigarette use.” The results of the 2018 National Youth Tobacco Survey showed that e-cigarette use rose by nearly 80 percent among high schoolers and 50 percent among middle schoolers from 2017 to 2018.

“We also recognize that not all of the cases may be reported,” wrote Gottlieb and Abernethy. “We believe these 35 cases warrant scientific investigation into whether there is in fact a connection.” Such seizures have been reported among first-time e-cigarette users and experienced users, and after a few puffs or up to one day after use.

The FDA is asking health care professionals and the public to report any unexpected health or safety issues involving e-cigarettes through the agency’s Safety Reporting Portal at https://www.safetyreporting.hhs.gov.

For more information, see the Psychiatric News article “Experts Call For More Action to Thwart Youth Vaping ‘Epidemic.’