Antidepressant drugs, convulsions and epilepsy.

Richens, A.; Nawishy, Salway; Trimble, Michael

doi:10.1111/j.1365-2125.1983.tb05878.x

Cited by 13 publications

(2 citation statements)

References 22 publications

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“…It is difficult to estimate whether this is a good reflection of the situation in the clinic. According to Richens et al [1983] there have been only a few reports of seizures fol lowing mianserin. Edwards and Glenn-Bott [1983] on the other hand conclude from clinical data that mianserin should be rated as high as amitriptyline and higher than imipramine concerning its (pro)convulsive activity.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the (Pro)convulsive Properties of Fluvoxamine and Clovoxamine with Eight Other Antidepressants in an Animal Model

1984

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Freely moving rats were implanted with cortical, caudal, thalamic, and reticular electrodes. Drugs were infused intravenously at a constant rate up to a final cumulative dose of 40, 50, or 60 mg/kg. Doses of 10 mg/kg imipramine, viloxazine, desmethylimipramine, mianserin, and maprotiline produced spike-wave complexes, spikes, and increased spindling. General sustained discharges occurred after 20 mg/kg of mianserin, viloxazine, imipramine, desmethylimipramine and amitriptyline, and after 30 mg/kg of maprotiline. An abnormal high-amplitude pattern was evident after mianserin, amitriptyline, imipramine, and desmethylimipramine. On the average, seizures were observed at 40 mg/kg and were seen after desmethylimipramine (50 mg/kg), mianserin (30 mg/kg), amitriptyline (20 mg/kg), imipramine (40 mg/kg), maprotiline (40 mg/kg), and zimelidine (50 mg/kg). Ranking the tested antidepressants in decreasing order in accordance with their relative (pro)convulsive properties gives:amitriptyline > mianserin >> imipramine > desmethylimipramine > viloxazine >> maprotiline >> zimelidine > clovoxamine > nomifensine = fluvoxamine.

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Section: Discussionmentioning

confidence: 99%

Comparison of the (Pro)convulsive Properties of Fluvoxamine and Clovoxamine with Eight Other Antidepressants in an Animal Model

1984

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“…The use of antidepressant drugs in epileptic patients has been a concern of clinicians because of reports that these drugs have proconvulsant or frank convulsant effects (Toone and Fenton, 1977;Trimble, 1978;Richens et al, 1983;Edwards et al, 1986). However, selective serotonin-uptake inhibitors, a relatively recent class of antidepressant drugs (Lemberger et al, 1985), have been reported to potentiate the anticonvulsant effects of the serotonin precursor, 5-hydroxytryptophan (SHTP), in mice (Buus Lassen, 1978).…”

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confidence: 99%

Fluoxetine, a Selective Serotonin‐Uptake Inhibitor, Enhances the Anticonvulsant Effects of Phenytoin, Carbamazepine, and Ameltolide (LY 201116)

1992

Epilepsia

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Dose-response curves for the prototypical anticonvulsants phenytoin (PHT) and carbamazepine (CBZ), and a novel anticonvulsant, ameltolide (LY201116), were determined with and without pretreatment with the selective serotonin-uptake inhibitor fluoxetine by maximal electroshock seizure (MES) test in mice. Fluoxetine (2.5, 5, and 10 mg/kg intraperitoneally, i.p.) produced a dose-related decrease in the ED50 values for the anticonvulsants (i.p. administration) to protect against MES-induced tonic-extensor seizures. Fluoxetine (10 mg/kg i.p.) also decreased the intravenous (i.v.) ED50 doses of the three anticonvulsants by a factor of approximately 2. These data suggest that fluoxetine, through its selective inhibition of serotonergic reuptake, may have beneficial advantages as compared with common antidepressant drugs in treatment of depressed patients with epilepsy and may also enhance the seizure control of prototypical anticonvulsants in treatment of epilepsy.

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Psychoactive Agents, Seizure Production, and Sudden Death in Epilepsy

Lipka

Lathers

1987

The Journal of Clinical Pharma

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Major tranquilizers as well as antidepressant agents have been associated with clinical seizures in patients administered these agents. The incidence of such seizures is generally low when these drugs are administered in therapeutic doses. However, administration of large doses of these agents has been associated with many cases of convulsion production. The effects that these drugs have on animal models of epilepsy have been examined. It appears that the phenothiazines act as convulsant agents at lower doses, whereas, at higher doses, they act as anticonvulsant drugs. Antidepressants, on the other hand, appear to exert an anticonvulsant effect at low doses and convulsant effects at high doses. The mechanism by which these agents alter the seizure threshold is not yet known. Clinically, drugs of lower seizure production potential should be substituted for those drugs with greater potential in treating epileptic patients for psychiatric ailments. The problem of sudden death in epileptic patients is one that must be confronted. Sudden death has most frequently been attributed to autonomic dysfunction and cardiac arrhythmia in these patients. The contribution of stress in sudden death production also must be taken into account. In addition, some psychoactive agents have been associated with sudden death as well as cardiac arrhythmia and seizure production. Thus, in light of the possible additivity of the factors involved in the production of sudden death, the administration of a psychoactive agent to an epileptic patient should be approached with caution. Those agents that do not alter cardiac rhythm or seizure threshold should be administered if a psychoactive agent is deemed necessary for the management of psychiatric illness in the epileptic patient.

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Antidepressant drugs, convulsions and epilepsy.

Cited by 13 publications

References 22 publications

Comparison of the (Pro)convulsive Properties of Fluvoxamine and Clovoxamine with Eight Other Antidepressants in an Animal Model

Comparison of the (Pro)convulsive Properties of Fluvoxamine and Clovoxamine with Eight Other Antidepressants in an Animal Model

Fluoxetine, a Selective Serotonin‐Uptake Inhibitor, Enhances the Anticonvulsant Effects of Phenytoin, Carbamazepine, and Ameltolide (LY 201116)

Psychoactive Agents, Seizure Production, and Sudden Death in Epilepsy

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