Sertraline and fluoxetine: Safe treatments for children and adolescents with epilepsy and depression

Anger Is a Distinctive Feature of Epilepsy Patients with Depression

“…Indeed, the safety of antidepressants-serotonin-reuptake inhibitors, in particular-among epilepsy patients has been widely demonstrated (Favale et al 1995;Hovorka et al 2000;Kühn et al 2003;Specchio et al 2004;Thomé-Souza et al 2007). However, efficacy has been successfully tested in only a handful of open, uncontrolled studies (Favale et al 1995;Hovorka et al 2000;Kühn et al 2003;Specchio et al 2004;Thomé-Souza et al 2007). The only double-blind, randomized controlled study conducted thus far failed to demonstrate the superiority of antidepressants over a placebo in patients with epilepsy, though the sample size was relatively small (Robertson and Trimble 1985).…”

A patient with partial seizures manifested as panic attacks and auditory hallucination

“…The epileptic symptoms in our patient showed no response to an SSRI, but completely disappeared after using carbamazepine. Although antiepileptic drugs are helpful for partial seizures, antidepressants occasionally worsen seizures [9][10], and these drug effects were also observed in our patient. Along with improvement of clinical seizures in our patient, decreased glucose metabolism in the frontal and temporal areas were also resolved.…”

The pharmacological management of psychiatric comorbidities in patients with epilepsy

“…The only double-blind trial on antidepressants in epilepsy was published 30 years ago and compared nomifensine, amitriptyline and placebo (11). Since then, a number of open trials in small samples of unselected patients with different epilepsy types have been published: sertraline (12,13), citalopram (14)(15)(16), reboxetine (15), mirtazapine (15), and fluoxetine (13). One study is of particular interest because it is the only published paper involving children and adolescents with epilepsy and depression (13).…”

“…Since then, a number of open trials in small samples of unselected patients with different epilepsy types have been published: sertraline (12,13), citalopram (14)(15)(16), reboxetine (15), mirtazapine (15), and fluoxetine (13). One study is of particular interest because it is the only published paper involving children and adolescents with epilepsy and depression (13). All these antidepressants showed to be effective and well tolerated but due to the lack of controlled about the pharmacological treatment of depression in epilepsy, the Epilepsy Foundation (17) and the International League Against Epilepsy (18) published a number of recommendations to guide clinicians.…”