For patients with TB and a seizure disorder, which medication is considered safer?

Isoniazid is recognized as a safer choice for patients with tuberculosis (TB) who also have a seizure disorder because it does not have a significant impact on seizure threshold or lead to an increase in the frequency of seizures.

This is important because some other anti-TB medications can have neurological side effects or may exacerbate seizure disorders. For example, Rifampicin can induce liver enzymes that may alter the metabolism of antiepileptic drugs, potentially leading to reduced efficacy and increased risk of seizures. Clofazimine and Prothionamide are generally used in multidrug-resistant TB but can also have neurological side effects, which might complicate the management of patients with a history of seizures.

Therefore, Isoniazid is often favored in this context, as it allows for effective treatment of TB while minimizing the risk of aggravating the patient's seizure condition.