Epileptiform EEG Patterns Induced by Mirtazapine in Both Psychiatric Patients and Healthy Volunteers

Juckel, Georg; Schüle, Cornelius; Pogarell, Oliver; Rupp, D.; Laakmann, G.; Hegerl, Ulrich

doi:10.1097/01.jcp.0000085422.74359.bb

Cited by 11 publications

(8 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ASMs and psychotropics are 2 major classes of commonly used centrally-acting medications that have been associated with iatrogenic epileptogenicity (acute cortical hyperexcitability), ranging from IEDs on EEG to de novo seizures. [1][2][3][4][5][6][7][8][9][10][11][12] The iatrogenic epileptogenicity often shows improvement to complete resolution with discontinuation or dose reduction of these medications. [1][2][3][4]6,7 Our 3 cases highlight the broad range of iatrogenic epileptogenicity that can be secondary to the use of ASMs and psychotropics.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Less recognized, central nervous system (CNS) medications may also induce iatrogenic epileptogenicity in individuals without a seizure disorder. [6][7][8][9][10][11][12] This review highlights 3 cases where CNS medications led to epileptogenicity ranging from interictal epileptiform discharges (IEDs) on electroencephalogram (EEG) to de novo seizures. [4][5][6][7][8][9][10][11][12][13] A literature review follows the case examples.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12] This review highlights 3 cases where CNS medications led to epileptogenicity ranging from interictal epileptiform discharges (IEDs) on electroencephalogram (EEG) to de novo seizures. [4][5][6][7][8][9][10][11][12][13] A literature review follows the case examples. We aim to improve patient care by raising awareness of these possible iatrogenic epileptic complications.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Iatrogenic Epileptogenicity Caused by CNS Drugs: A Short Case Series and Narrative Review

Morgan,

Punia

2024

The Neurohospitalist

View full text Add to dashboard Cite

Multiple medications are known to increase epileptogenicity in patients with and without an underlying seizure disorder. Paradoxically, some of these medications include anti-seizure medications (ASMs) and other medications, such as psychotropics, that act on the central nervous system (CNS). This article aims to discuss 3 clinical cases that highlight the gamut of epileptogenic reactivity secondary to CNS drugs ranging from increased epileptogenicity in the form of interictal epileptiform discharges (IEDs) without seizures, increased epileptogenicity on electroencephalogram (EEG) with associated non-epileptic movement disorders, and frank, de novo seizures. We also analyze the relevant literature on the impact of CNS medications on epileptogenicity.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Iatrogenic Epileptogenicity Caused by CNS Drugs: A Short Case Series and Narrative Review

Morgan,

Punia

2024

The Neurohospitalist

View full text Add to dashboard Cite

show abstract

“…Munchau et al 14 showed that mirtazapine is able to increase cortical excitability both in healthy volunteer and depressed epilepsy patients. Juckel et al 15 reported that mirtazapine monotherapy in depressed patients could induce epileptiform EEG patterns without clinical epileptic symptoms. Therefore, we could not completely rule out the possible action of mirtazapine in inducing sleepwalking by production of epileptic discharges, despite that there was no detectable epileptic discharge and seizure motor behavior.…”

Section: Discussionmentioning

confidence: 99%

New Onset Somnambulism Associated With Different Dosage of Mirtazapine

Yeh

Chen²,

Feng³

et al. 2009

Clinical Neuropharmacology

View full text Add to dashboard Cite

Somnambulism consists of variously complex behaviors that may result in harm to self or to others. Many different medications have been reported to induce somnambulism, and a few of them are newer antidepressants. A 40-year-old woman with history of major depression who experienced new onset somnambulism for successive 3 nights, whereas the antidepressant mirtazapine was increased from 30 to 45 mg/d. The notable and complex sleepwalking symptoms terminated dramatically on the first night after withdrawal of mirtazapine. There is clearly a cause-and-effect relationship between the treatment of higher-dosage mirtazapine and development of somnambulism. It might be related to the different affinities to 5-hydroxytryptamine 2 (5-HT(2)) and H(1) receptors at different dosages of mirtazapine, which explain the patient experiencing sleepwalking episodes exclusively at higher doses of mirtazapine. Clinical physicians should be aware of this adverse effect and taper or discontinue the regimen if sleepwalking develops.

show abstract

“…We firmly hold that such a radical methodological realignment represents both the absolute minimum of technical expenditure as well as the optimum with regard to the attainable reliability. This is important not only to improve the potential to detect subtle EEG changes induced by psychotropic agents [5,6] but also for elaborated approaches such as LORETA [7]. Furthermore, we hold that the exclusion of the EEG waves below 2Hz and above 15Hz will not have any negative impact on the information content provided by the Cerebral Global Function (CGF).…”

Section: Implications Of the Hypothesismentioning

confidence: 99%

The impact of Arterial Pulse Impedance Artifact (APIA) on test-retest reliability of quantitative EEG

Ulrich

Schlösser

Juckel

2016

Neuropsychiatr Electrophysiol

Self Cite

View full text Add to dashboard Cite

Background: We report on a biological artifact that is unknown in the EEG-literature, presumably due to its invisibility in the unfiltered raw EEG. On account of its probable electrogenesis, we discuss Arterial Pulse Impedance Artifact (APIA). One may also call it a virtual artifact because it only becomes manifest as the averaged mean value of power spectra from consecutive 2s epochs across a total length of 5 min (150 epochs). Presentation of the hypothesis: APIA has a cardiac origin, mediated by the superficial head arteries. The arterial pulse induces rhythmic changes in the electrical impedance between the cortical generator inside the skull and the recording electrode that is outside.

show abstract

Epileptiform EEG Patterns Induced by Mirtazapine in Both Psychiatric Patients and Healthy Volunteers

Cited by 11 publications

References 7 publications

Iatrogenic Epileptogenicity Caused by CNS Drugs: A Short Case Series and Narrative Review

Iatrogenic Epileptogenicity Caused by CNS Drugs: A Short Case Series and Narrative Review

New Onset Somnambulism Associated With Different Dosage of Mirtazapine

The impact of Arterial Pulse Impedance Artifact (APIA) on test-retest reliability of quantitative EEG

Contact Info

Product

Resources

About