PsychoTropicalResearch, serotonin and serotonin syndrome research.
Antidepressants - Epilepsy
Antidepressants - Epilepsy
Many antidepressants may be slightly 'pro-convulsant' or epileptogenic.
The quality of the clinical evidence on this question is relatively poor; effects may be anti- or pro- convulsant at different doses. Indeed the quality of reviews on this subject in psychiatric journals and texts is such that most reviewers appear to be quite unaware of the evidence that MAOIs are anti-epileptic in animal models of epilepsy. Such evidence has existed for several decades.
It seems that most neurologists agree that for most antidepressant drugs (including TCAs) the degree by which they lower the seizure threshold is rarely of clinical significance, as far as treatment of patients with epilepsy that is already under control is concerned.
Risk estimate of therapeutic doses lowering seizure threshold (best estimate from available data).
(See also notes on 'toxicity'.)
Most epileptogenic
venlafaxine, dothiepin, bupropion, amitriptyline, mianserin, imipramine.
Somewhat less epileptogenic
lithium, clomipramine.
Least epileptogenic
sertraline, fluoxetine, paroxetine.
Anti-epileptic
moclobemide (and presumably other RIMAs) and MAOIs.
All text ©Dr Ken Gillman MRC Psych - PsychoTropical Research®
|Return to the menu at the top of this page|