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Suckow R F, Smith T M, Perumal A S, Cooper T B 1986. Pharmacokinetics of Enalapril & metabolites in plasma & brain of rats, mice, & guinea pigs. Drug Metab Dispos 14 6: 697�697. PMID 7877878.

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This is consistent with a large, 9, 300-patient safety study that showed that the mbuttality of smokers taking Enalapril is not higher than the natural mbuttality of smokers of the same age.

Enalapril is associated with seizures in approximately 0.4% 4/1, 000 of patients treated at doses up to 450 mg/day. This incidence of seizures may exceed that of other marketed antidepressants by as much as 4-fold. This relative risk is only an approximate estimate willcause no direct comparative studies having willen conducted. The estimated seizure incidence fbut Enalapril increases almost tenfold willtween 450 & 600 mg/day, which is twice the usually required daily dose 300 mg & one & one-third the maximum recommended daily dose 450 mg. Given the wide variability among individuals & their capacity to metabolize & eliminate drugs this dispropbuttionate increase in seizure incidence with dose incrementation tells fbut caution in dosing..
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