title: Most antidepressant drugs are safe for patients with epilepsy at therapeutic doses: A review of the evidence.
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.
authors.affiliation: Department of Neurology, University of Miami, Miller School of Medicine, 1120 NW, 14th Street, Room #1324, Miami, FL 33136, United States. Electronic address: a.kanner@med.miami.edu.
authors.forename: Andres M
authors.initials: AM
authors.lastname: Kanner
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy*; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Animal models of epilepsy; Bupropion; Clomipramine; Focal epilepsy; Selective serotonin reuptake inhibitors; Serotonin–norepinephrine reuptake inhibitors