Most antidepressant drugs are safe for patients with epilepsy at therapeutic doses: A review of the evidence

Epilepsy Behav. 2016 Aug;61:282-286. doi: 10.1016/j.yebeh.2016.03.022. Epub 2016 May 25.

Abstract

For a long time, there has been a misconception that all antidepressant drugs have proconvulsant effects. Yet, antidepressants of the selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) families have been not only shown to be safe when used in patients with epilepsy (PWE) but have been found to display antiepileptic properties in animal models of epilepsy. In humans randomized to SSRIs vs. a placebo for the treatment of primary major depressive episodes, the incidence of epileptic seizures was significantly lower among those treated with the antidepressants. On the other hand, SSRIs and SNRIs can display proconvulsant properties at toxic doses. This article reviews the preclinical and clinical data of antiepileptic and proconvulsant properties of these drugs and addresses special considerations to take when prescribing them for PWE.

Keywords: Animal models of epilepsy; Bupropion; Clomipramine; Focal epilepsy; Selective serotonin reuptake inhibitors; Serotonin–norepinephrine reuptake inhibitors.

Publication types

  • Review

MeSH terms

  • Anticonvulsants / therapeutic use
  • Antidepressive Agents / adverse effects*
  • Antidepressive Agents / therapeutic use
  • Depressive Disorder, Major / complications
  • Depressive Disorder, Major / drug therapy*
  • Epilepsy / complications*
  • Epilepsy / drug therapy
  • Humans
  • Serotonin Uptake Inhibitors / adverse effects*
  • Serotonin Uptake Inhibitors / therapeutic use

Substances

  • Anticonvulsants
  • Antidepressive Agents
  • Serotonin Uptake Inhibitors