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Seizure possibly associated with fluvoxamine
K Y Kim1, J M Craig, J M Hawley
1Department of Psychiatric Medicine, School of Medicine, University of Virginia, Charlottesville, USA. kyekim726@aol.com
The Annals of Pharmacotherapy
|December 1, 2000
Summary
Therapeutic doses of fluvoxamine may trigger seizures, even in patients with a history of head trauma. Clinicians should exercise caution, particularly with patients having prior seizure history.
Area of Science:
- Neuroscience
- Pharmacology
- Psychiatry
Background:
- Selective serotonin-reuptake inhibitors (SSRIs) like fluvoxamine are commonly prescribed for psychiatric conditions.
- While generally considered safe, SSRIs can have potential adverse effects, including seizures.
- A history of seizures or head trauma may increase seizure risk in patients taking SSRIs.
Observation:
- A patient with schizoaffective disorder and a history of seizures experienced a breakthrough seizure while on therapeutic doses of fluvoxamine.
- The patient was also receiving anticonvulsants for his mood disorder.
- No other underlying medical conditions were identified as the cause of the seizure.
Findings:
- The seizure occurred at a therapeutic dosage of fluvoxamine, suggesting it may not be solely an overdose phenomenon.
- Seizures associated with fluvoxamine have been reported more frequently with overdose.
- The patient's seizure risk factors included a past history of seizures and head trauma.
Implications:
- Clinicians should be aware of the potential for fluvoxamine-induced seizures, even at therapeutic doses.
- Caution is advised when prescribing fluvoxamine to patients with a history of seizures or head trauma.
- This case highlights the importance of considering all potential contributing factors, including concurrent psychotropic medications, when evaluating seizures in patients treated with SSRIs.