On the risk for an increase of seizure activity in patients with therapy refractory epilepsy under medication with SSRI

Because an increase of seizure activity is suspected patients with epilepsy and depression are rarely treated with an antidepressive drug. In this retrospective Study we investigated whether there are hints for an increase of seizure activity in patients with epilepsy and depression when additionally treated with a selective serotonin reuptake inhibitor (e.g. citalopram, sertraline). For this purpose seizure frequency and seizure severity. antiepileptic medication and duration of indoor treatment were analysed in 50 patients with epilepsy and depression. 14 patients were additionally treated with citalopram or sertraline. There were no significant differences in the parameters under concern between this group of patients and the 36 patients with epilepsy and depression, which were only treated with a change of antiepileptic drugs and a psychosocial therapy program. The increase in seizure activity in patients with epilepsy under additional treatment with citalopram or sertraline is obviously so small that it can not be documented statistically in small groups of patients. If depressive comorbidity in patients with epilepsy requires pharmacological treatment, the indication for antidepressive drug medication should not be delayed because an increase of seizure activity is suspected.