Epileptic Seizures Under Antidepressive Drug Treatment: Systematic Review

Steinert, Tilman; Fröscher, W.

doi:10.1055/s-0043-117962

Cited by 32 publications

(28 citation statements)

References 160 publications

(52 reference statements)

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“…An exception been for clomipramine at high doses (>150 mg), maprotiline, bupropion immediate release formulation [70]. These findings have been recently confirmed by a systematic review on this subject [94].…”

Section: Seizure Worseningmentioning

confidence: 82%

Developments in depression in epilepsy: screening, diagnosis, and treatment

Mula

2019

Expert Review of Neurotherapeutics

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Introduction: Depression is one of the most frequent comorbidities in epilepsy affecting between 17% and 22% of patients but it is still underdiagnosed and undertreated. Areas covered: This paper discusses recent advances about screening, diagnosis and treatment of depression in epilepsy taking into account the heterogeneity of clinical scenarios where depression can occur. Expert opinion: A number of screening instruments are now validated for adults with epilepsy and their psychometric properties are discussed but the NDDIE is the most practical and cost-effective. Challenges in diagnosing depression in epilepsy are discussed including reasons for the atypical features of mood disorders in epilepsy. Psychological treatments and/or SSRIs are indicated but the level of evidence is still low. Even if there is no reason to hypothesis that internationally accepted guidelines of treatment of depression outside epilepsy may not be valid, rigorous studies are needed in order to have proper outcome measures. Epilepsy centers should have well-defined care pathways for depression in order to provide access to mental health support when needed.

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Section: Seizure Worseningmentioning

confidence: 82%

Developments in depression in epilepsy: screening, diagnosis, and treatment

Mula

2019

Expert Review of Neurotherapeutics

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“…Whereas tricyclic antidepressants (TCAs) have long been recognized to trigger seizures in persons without epilepsy, growing evidence suggests that newer antidepressants such as SSRIs may potentially lead to reductions in seizure frequency and severity in persons with epilepsy,[15, 29–31] although most studies on the effects on seizures have been descriptive. [32–34] Few studies have evaluated whether antidepressants may influence the processes associated with development of epilepsy after an insult (i.e. epileptogenesis).…”

Section: Discussionmentioning

confidence: 99%

Selective serotonin reuptake inhibitors and risk of epilepsy after traumatic brain injury – A population based cohort study

et al. 2019

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Objective Traumatic brain injury (TBI) is common and associated with a marked increased risk of developing epilepsy. Animal studies indicate that treatment with selective serotonin reuptake inhibitors (SSRIs) may increase the risk of epilepsy after TBI. The aim of this study was to investigate whether use of SSRIs modifies the risk of epilepsy after TBI. Methods This was a cohort study of 205,715 persons, who suffered a TBI in Denmark from 1996 to 2013. For each person with TBI, we matched 10 reference persons (N = 2,057,150) who were alive on the day of TBI and who had the same age and gender but had no history of TBI. We used a stratified Cox regression to calculate the relative risk of epilepsy after TBI for persons exposed to TBI, SSRI or both after adjustment for income, civil status, medical and neurological comorbidities, severe mental disease, and substance abuse. Results The risk of epilepsy was 5.61 times higher for persons who used SSRI at time of TBI (adjusted Hazard Ratio (aHR): 5.61 (95% CI: 4.88; 6.45)), 3.23 times higher for persons who had a TBI but did not use SSRI at time of TBI (aHR: 3.23 (95% CI: 3.12;3.35)), and 1.31 times higher for persons who used SSRI but had no TBI (aHR: 1.31 (95% CI: 1.18; 1.45)) compared to persons unexposed to both TBI and SSRI. Conclusions This large population based cohort study showed that people using SSRI at the time of a TBI had higher risk of developing epilepsy compared to people not using SSRI at the time of TBI. The results are in line with those of animal studies and calls for further studies to evaluate whether the association is due to SSRIs or to the underlying disease (e.g. depression or anxiety).

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“…The only exception was for clomipramine at high doses (>150 mg) which showed a standardised incidence ratio of 4 [20]. These findings have recently been confirmed in a systematic review [52].…”

Section: Is the Management Of Psychiatric Disorders In Pte Different mentioning

confidence: 60%

Psychiatric aspects of posttraumatic epilepsy: A still unexplored area

Mula

2019

Epilepsy & Behavior

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Traumatic brain injury (TBI) represents one of the most common causes of death and disability in young people and post-traumatic epilepsy (PTE) accounts for 10% to 20% of all symptomatic epilepsies. However, PTE is still a relatively underappreciated condition. This paper is aimed at reviewing current knowledge about psychiatric comorbidities of PTE, looking in particular at the nature of the relationship between traumatic brain injury, psychiatric problems and epilepsy, at the phenomenology of psychiatric disorders in PTE and how to manage them. Data on psychiatric comorbidities of PTE are almost non-existing and this is a paradox considering that TBI itself is burdened by a number of cognitive and psychiatric sequalae which can profoundly affect the everyday life of these patients. Preliminary data seem to suggest that the bidirectional relationship between epilepsy and psychiatric disorders is maintained in TBI and people with a psychiatric condition at the time of the TBI, or as a consequence of it, are at increased risk of developing PTE and vice versa. However, a number of questions are still unanswered concerning the genetic and environmental contributors, the phenomenology of psychiatric disorders in PTE and how to prevent and address them properly. Further research in this area is urgently needed in order to provide the best possible care to people with PTE.

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Epileptic Seizures Under Antidepressive Drug Treatment: Systematic Review

Abstract: Antidepressive treatment is rather safe in terms of risk of seizures and also can be generally recommended in the treatment of patients with epilepsy.

Cited by 32 publications

References 160 publications

Developments in depression in epilepsy: screening, diagnosis, and treatment

Developments in depression in epilepsy: screening, diagnosis, and treatment

Selective serotonin reuptake inhibitors and risk of epilepsy after traumatic brain injury – A population based cohort study

Psychiatric aspects of posttraumatic epilepsy: A still unexplored area

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