Do anti-depressants affect seizure control?
The newer antidepressants were designed not to be toxic/lethal in overdose as compared to the older TCA antidepressants. They are significantly safer and have fewer side effects. The newer antidepressants are generally associated with no change in seizure frequency and may even decrease seizure frequency in some people with epilepsy.22,23,24,25,26,27,28,29 They may help seizure control by alleviating emotional distress and depression (which are triggers for seizures), by improving compliance, AED levels and functioning. Generally the newer SSRI antidepressants should be considered first choice in the medical treatment of depression in epilepsy. There was much concern and caution regarding the use of older TCA antidepressant medication as these could lower seizure threshold and be associated with seizures at toxic/higher doses.10,30,31,32,33,34,35,36 Although they do have a higher risk of causing seizures most observations have found this not to be clinically significant.10,30,31,32,33,
