Antidepressants May Lead to Fewer Seizures in People With Epilepsy

Research is preliminary, but could encourage more people with depression and epilepsy to try meds

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By Robert Preidt

Monday, December 3, 2012

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MONDAY, Dec. 3 (HealthDay News) -- Besides helping to boost mood, antidepressants may also reduce seizure frequency for people with epilepsy, a new study suggests.
The study, to be presented Monday at the annual meeting of the American Epilepsy Society in San Diego, included patients who were prescribed one of two types of antidepressants -- selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). These types include drugs such as Celexa, Paxil, Prozac and Zoloft, among others.
Researchers led by Dr. Ramses Ribot, of Rush University Medical Center in Chicago, tracked changes in mood and anxiety levels for 100 people with epilepsy at three and six months after the start of antidepressant therapy.
Improvement or remission of symptoms was seen in 86 percent of patients, the investigators found.
The antidepressants tested "do not appear to worsen seizure frequency and yield a good therapeutic response independently of seizure frequency," Ribot said in a society news release. "Our studies also suggest these antidepressants may actually have an anti-seizure effect in patients with frequent seizures," he added.
The researchers said the findings should be of interest to doctors who treat people with epilepsy, but the results need to be confirmed in further studies.
One epilepsy expert said the findings are reassuring for doctors and patients.
"This study provides additional support for the safety and effectiveness of antidepressant medications in patients with epilepsy and comorbid [co-existing] depression," said Dr. Orrin Devinsky, director of the Comprehensive Epilepsy Center at NYU Langone Medical Center in New York City.
He explained that, in rare cases in the past, SSRIs and SSNIs have been linked to a lowering of the threshold at which epileptic seizures might occur.
"This has unfortunately led many psychiatrists and neurologists to avoid the use of these medications in epilepsy patients," Devinsky said. "However, the findings of Ribot and colleagues provide clear support that depressed patients with epilepsy should be treated with effective doses of these medications. Further, these medications can improve depression and quality of life and, in many patients, reduce seizure frequency."
While the study found an association between antidepressant use and reduced seizure activity, it did not prove a cause-and-effect relationship.
Findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

SOURCES: Orrin Devinsky, M.D., director, Comprehensive Epilepsy Center, NYU Langone Medical Center, New York City; American Epilepsy Society, news release, Dec. 3, 2012

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