Pilot pharmacologic randomized controlled trial for psychogenic nonepileptic seizures

Area of Science:

• Neurology
• Psychiatry
• Clinical Trials

Background:

• Psychogenic nonepileptic seizures (PNES) have limited treatment options.
• Psychotherapies show some efficacy for PNES and associated symptoms.
• Pharmacologic interventions for PNES require further evaluation.

Purpose of the Study:

• To assess the efficacy of sertraline in reducing PNES.
• To test the hypothesis that sertraline decreases seizure frequency in PNES patients.
• To gather feasibility data for larger PNES treatment trials.

Main Methods:

• A pilot, double-blind, randomized, placebo-controlled trial was conducted.
• Adult patients with video-EEG-confirmed PNES received flexible-dose sertraline or placebo for 12 weeks.
• Seizure rates, psychiatric symptoms, and psychosocial variables were monitored.

Main Results:

• Sertraline treatment resulted in a 45% reduction in PNES rates (p=0.03).
• Placebo group showed an 8% increase in PNES rates (p=0.78).
• No significant differences in secondary outcomes were observed between groups.

Conclusions:

• Sertraline, a serotonin selective reuptake inhibitor, demonstrated a reduction in PNES.
• The study provides feasibility data for a larger-scale randomized controlled trial.
• Flexible-dose sertraline (up to 200 mg) showed a trend towards PNES reduction versus placebo.