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Antidepressant drugs use and epilepsy risk: A nationwide nested case-control study
Che-Sheng Chu1, Fang-Lin Lee2, Ya-Mei Bai3
1Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Non-invasive Neuromodulation Consortium for Mental Disorders, Society of Psychophysiology, Taipei, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Epilepsy & Behavior : E&B
|February 6, 2023
Summary
Long-term antidepressant use, particularly with cumulative defined daily doses over 365, is linked to a higher risk of epilepsy. Certain antidepressants like escitalopram and venlafaxine showed increased epilepsy risk, while others did not.
Area of Science:
- Neuroscience
- Pharmacology
- Epidemiology
Background:
- Antidepressants (ADs) are widely prescribed, but their association with epilepsy risk requires further investigation.
- Understanding potential neurological side effects of ADs is crucial for patient safety.
Purpose of the Study:
- To examine the relationship between antidepressant exposure and the incidence of epilepsy.
- To identify specific antidepressants or dosage thresholds associated with increased epilepsy risk.
Main Methods:
- A case-control study utilized Taiwan's National Health Insurance Research Database (1998-2013).
- Included 863 epilepsy cases and 3,452 controls, analyzing antidepressant dosage via cumulative defined daily dose (cDDD).
- Conditional logistic regression assessed epilepsy risk, adjusting for comorbidities and indications for AD use.
Main Results:
- Antidepressant exposure with cDDD > 365 days showed a 1.37-fold increased epilepsy risk (OR: 1.37, 95% CI: 1.12-1.68) compared to cDDD < 90.
- Escitalopram, venlafaxine, mirtazapine, paroxetine, and fluoxetine were associated with significantly higher epilepsy risks.
- Risk factors like cerebrovascular disease and TBI also correlated with epilepsy.
Conclusions:
- Longer-term antidepressant use is associated with an elevated risk of epilepsy.
- While some antidepressants showed proconvulsant effects, others did not, suggesting differential risks.
- Caution is advised when interpreting findings due to the observational nature of the study.
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