Antidepressant-associated myoclonic status in a patient with symptomatic generalized epilepsy: does risk occur with therapeutic doses?

Epilepsy Behav. 2009 Apr;14(4):681-3. doi: 10.1016/j.yebeh.2009.01.018. Epub 2009 Jan 31.

Abstract

The clinical and EEG data of a 49-year-old man with myoclonic and generalized tonic-clonic seizures resulting from early childhood encephalitis are described. He experienced no tonic-clonic seizure for 10 years before brief exposure first to 60 mg/day duloxetine and then to 20mg/day paroxetine for depressive symptoms. These drugs were separately prescribed at a 9-month interval, and after beginning each drug, the patient experienced tonic-clonic seizures of worsening intensity and myoclonus of increasing frequency. Clinical features correlated with subcontinuous, generalized spike-wave discharges on the EEG. Discontinuation of antidepressant treatment resulted in rapid disappearance of clinical and electrophysiological manifestations of myoclonic status. We suggest care must be taken when using serotonin-noradrenaline reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs), as these drugs pose the risk of complications in the specific population of people with myoclonic seizures.

Publication types

  • Case Reports

MeSH terms

  • Antidepressive Agents / adverse effects*
  • Depression / drug therapy
  • Depression / etiology
  • Duloxetine Hydrochloride
  • Electroencephalography
  • Epilepsy, Generalized / chemically induced*
  • Humans
  • Male
  • Middle Aged
  • Paroxetine / adverse effects*
  • Seizures / complications
  • Seizures / drug therapy
  • Thiophenes / adverse effects*

Substances

  • Antidepressive Agents
  • Thiophenes
  • Paroxetine
  • Duloxetine Hydrochloride