scholarly journals Which is the safest antidepressant to use in epilepsy?

1995 ◽  
Vol 19 (6) ◽  
pp. 355-356 ◽  
Author(s):  
Denise Duncan ◽  
David Taylor
Keyword(s):  
Adverse Effect ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Seizure Threshold

Seizures are a serious adverse effect of many antidepressants: most, if not all, tricyclics (TCAs) lower the seizure threshold, some atypicals (e.g. maprotiline) are known to cause convulsions and seizures have been reported to occur with all selective serotonin reuptake inhibitors (SSRIs). Opinions vary on which is the safest antidepressant to use in epilepsy.

Discontinuing or Switching Selective Serotonin-Reuptake Inhibitors

2002 ◽  
Vol 36 (4) ◽  
pp. 578-584 ◽  
Author(s):  
Scott A Bull ◽  
Enid M Hunkeler ◽  
Janelle Y Lee ◽  
Clayton R Rowland ◽  
Todd E Williamson ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Adverse Effects ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Early Discontinuation ◽  
Telephone Surveys ◽  
Recurrent Case ◽  
Frequent Reason

OBJECTIVE: To describe reasons for discontinuing or switching selective serotonin-reuptake inhibitors (SSRIs) at 3 and 6 months after starting treatment, and to identify information provided to patients that may help prevent premature discontinuation of medication. METHODS: Telephone surveys were conducted at 3 and 6 months after patients (n = 672) were started on an SSRI for a new or recurrent case of depression. RESULTS: Significantly more patients discontinued or switched their SSRI because of an adverse effect within the first 3 months of starting (43%) compared with the second 3 months (27%; p = 0.023). The adverse effect most frequently reported as the reason for early discontinuation or switching was drowsiness/fatigue (10.2%), followed by anxiety, headache, and nausea — All at just over 5%. The odds ratio for discontinuation was 61% less in patients who recalled being told to take the medication for at least 6 months compared with those who did not (OR 0.39; p < 0.001). Patients who recalled being informed of potential adverse effects increased their reported incidence of mild to moderate adverse effects by 55% (OR 1.55; p < 0.05) without affecting rates of premature discontinuation (OR 1.06; p = 0.77). CONCLUSIONS: Adverse effects are the most frequent reason for discontinuing or switching SSRIs within the first 3 months of treatment. Patients are more likely to continue taking their antidepressant if they fully understand how long to take the medication. Informing patients of potential adverse effects does not appear to prevent premature discontinuation, but may increase the patient's awareness and reporting of mild to moderate adverse effects.

scholarly journals Non-epileptic seizure caused by selective serotonin reuptake inhibitors (SSRI) - case report

2021 ◽  
Author(s):  
André Douglas Marinho da Silva ◽  
Ana Caroline Fonseca Silva ◽  
Lucas Pablo Almendro ◽  
Pedro da Cunha Dantas
Keyword(s):  
Case Report ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Medication Management ◽  
Antidepressant Drugs ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Seizure Threshold ◽  
Seizure Event ◽  
Patient Reported

Context: Seizures are the most frequent clinical emergency neurological manifestation, corresponding to 1-5% of the visits, except for trauma. Several conditions have the potential to reduce the seizure threshold, and the use of antidepressant drugs as selective serotonin reuptake inhibitors is one of those reported. The seizure triggering risk related to SSRIs use is low, being 0.1%, perceptibly lower than that of tricyclic antidepressants, with a 1% rate. Case report: Male patient, previously healthy, 23-year-old, was seen at the Emergency Room in Rio Branco after a generalized seizure lasting 3 minutes. Complementary exams, including computed tomography, were all normal. Magnetic resonance imaging of the skull without atypical findings and electroencephalogram showed dysrhythmia by waves and discrete spicules. Patient reported using escitalopram (esc) 20mg for 3 months after 10mg progression dose, in use for 1 year, without clinical improvement. Due to the seizure event, medication management was switched for sertraline 50mg intake. After 2 months, the patient had a new generalized seizure, preceded by prolonged depersonalization. Complementary exams were normal, 10mg of esc was reestablished and the patient ceased with the seizures. Conclusions: The diagnostic hypothesis: patient’s seizure threshold is low, and seizures are triggered by SSRI higher doses adverse effect. Due to case rarity and SSRI efficacy and tolerance, it is suggested to encourage the discussion about administration safety of these drugs.

Selective Serotonin-Reuptake Inhibitors in the Treatment of Premature Ejaculation

2005 ◽  
Vol 39 (7-8) ◽  
pp. 1296-1301 ◽  
Author(s):  
Amanda J Moreland ◽  
Eugene H Makela
Keyword(s):  
Adverse Effect ◽  
Serotonin Reuptake ◽  
Literature Search ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Premature Ejaculation ◽  
Case Reports ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Level Of Evidence ◽  
Medline Search

OBJECTIVE To review the use of selective serotonin-reuptake inhibitors (SSRIs) in the treatment of premature ejaculation. DATA SOURCES Articles were retrieved through a MEDLINE search (1966–January 2004). Search terms used to identify articles included serotonin uptake inhibitors, premature ejaculation, rapid ejaculation, and sexual behavior, as well as the generic names of currently available SSRIs: fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, and escitalopram. The literature search was limited to articles published in the English language containing human subjects. STUDY SELECTION AND DATA EXTRACTION Articles obtained through the literature search were evaluated, and randomized controlled trials were included in this review. Information from noncontrolled trials or case reports was considered for inclusion if it contributed to the completeness of this review and if it was the highest level of evidence available. DATA SYNTHESIS Premature ejaculation is a commonly reported sexual difficulty. Delayed ejaculation is a widely reported sexual adverse effect of SSRIs. In some men exhibiting premature ejaculation, the ability of the SSRIs to delay ejaculation has been therapeutic. Trials evaluating the ejaculation-delaying ability of SSRIs demonstrated that paroxetine, fluoxetine, sertraline, and citalopram produce a statistically significant increase in the ejaculation latency time compared with placebo. CONCLUSIONS Taking advantage of the ejaculation-delaying effects of SSRIs increases the treatment options available to prescribers and patients. Convenience and minimal adverse effect profile make these agents an alternative to previously used behavior modalities and older pharmacologic agents. Although some questions still surround the details of their use, SSRIs have the potential to improve the quality of life for men with premature ejaculation and their partners.

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