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DOI: 10.1055/s-2005-918623
Drug safety monitoring in psychiatry: drug induced seizures in antidepressant treatment
Aim of the presented study was to investigate epileptic seizures in AD treatment under natural conditions. The AMSP (Arzneimittelsicherheit in der Psychiatrie) project is a drug safety program for the assessment of adverse drug reactions (ADR) of psychotropic drugs (1). Data collection started in 1993, in 2003 40 psychiatric hospitals in Germany, Austria and Switzerland participate. 78.155 patients treated with AD were monitored (32.311 patients under tricyclic antidepressants (TCA), 27.454 under serotonin reuptake inhibitors (SSRI)). Totally 58 cases of Grand mal seizure were recorded (0,07%). The incidence rates were highest for TCA with 0,04%, followed by SSRI (0,02%). Within the TCA class the incidence rates were: maprotiline 0,03%, doxepin/clomipramine 0,02%. Within the SSRI class paroxetine (0,02%), sertralin (0,01%) were the most relevant associated with seizure. We recorded incidence rates of 0,008% in mirtazapine/venlafaxine. In about half of all drug-induced seizures, combination treatments with other psychotropic drugs were imputed. There was a strong difference between the AD groups. Combination treatment seems to be the most relevant risk factors for seizures (pharmacodynamic and -kinetic interactions). The systematic assessment of ADR due to AD by the AMSP project can yield data for establishing risk profiles of single drugs.