fluvoxamine and Epilepsy

Topics: Anti-Anxiety Agents; Cognition Disorders; Epilepsy; ERG1 Potassium Channel; Ether-A-Go-Go Potassium Channels; Female; Fluvoxamine; Humans; Long QT Syndrome; Middle Aged; Multiple Sclerosis; Obsessive-Compulsive Disorder; Potassium Channel Blockers; Schizophrenia; Selective Serotonin Reuptake Inhibitors; Treatment Outcome

A case of forced normalization in childhood is presented. When zonisamide was administered to a five-year-old girl with intractable epilepsy, disappearance of seizures was accompanied by severe psychotic episodes such as communication disturbance, personal relationship failure, and stereotyped behavior, which continued after the withdrawal of zonisamide. These symptoms gradually improved by administration of fluvoxamine, however epileptic attacks reappeared. Although most patients with forced normalization are adult and teenager, attention should be paid to this phenomenon as adverse psychotic effects of zonisamide even in young children. Fluvoxamine may be effective for the symptoms.

Topics: Anticonvulsants; Child Behavior Disorders; Child, Preschool; Communication Disorders; Electroencephalography; Epilepsy; Female; Fluvoxamine; Humans; Isoxazoles; Psychoses, Substance-Induced; Zonisamide

Many patients with affective illness show partial or otherwise unsatisfactory responses to standard treatments, encouraging trials of combinations of pharmacologically dissimilar antidepressants.. Records of consecutive outpatients with affective disorders only partially responsive to treatment with a serotonin reuptake inhibitor (SRI) or bupropion, alone, were reviewed for changes in specific symptoms and risks of adverse events when an SRI and bupropion were combined.. Greater symptomatic improvement was found in 19 (70%) of 27 subjects during a mean +/- SD of 11 +/- 14 months of combined daily use of bupropion (243 +/- 99 mg) with an SRI (31 +/- 16 mg fluoxetine-equivalents) than with either agent alone. Adverse effect risks were similar to those associated with each monotherapy, with a > 10% incidence of sexual dysfunction (N = 11, 41%), insomnia (N = 6, 22%), anergy (N = 4, 15%), and tremor (N = 3, 11%) during combined therapy; there were no seizures.. With conservative dosing and close monitoring, combinations of SRIs with bupropion in this uncontrolled clinical series appeared to be safe and often more effective than monotherapy.

Topics: 1-Naphthylamine; Adult; Aged; Ambulatory Care; Anxiety Disorders; Bupropion; Depressive Disorder; Drug Administration Schedule; Drug Therapy, Combination; Dysthymic Disorder; Epilepsy; Female; Fluoxetine; Fluvoxamine; Humans; Male; Middle Aged; Panic Disorder; Selective Serotonin Reuptake Inhibitors; Sertraline; Treatment Outcome

Topics: Antidepressive Agents; Contraindications; Epilepsy; Fluvoxamine; Humans; Male; Oximes; Product Surveillance, Postmarketing

Freely moving rats were implanted with cortical, caudal, thalamic, and reticular electrodes. Drugs were infused intravenously at a constant rate up to a final cumulative dose of 40, 50, or 60 mg/kg. Doses of 10 mg/kg imipramine, viloxazine, desmethylimipramine, mianserin, and maprotiline produced spike-wave complexes, spikes, and increased spindling. General sustained discharges occurred after 20 mg/kg of mianserin, viloxazine, imipramine, desmethylimipramine and amitriptyline, and after 30 mg/kg of maprotiline. An abnormal high-amplitude pattern was evident after mianserin, amitriptyline, imipramine, and desmethylimipramine. On the average, seizures were observed at 40 mg/kg and were seen after desmethylimipramine (50 mg/kg), mianserin (30 mg/kg), amitriptyline (20 mg/kg), imipramine (40 mg/kg), maprotiline (40 mg/kg), and zimelidine (50 mg/kg). Ranking the tested antidepressants in decreasing order in accordance with their relative (pro)convulsive properties gives: amitriptyline greater than mianserin much greater than imipramine greater than desmethylimipramine greater than viloxazine much greater than maprotiline much greater than zimelidine greater than clovoxamine greater than nomifensine = fluvoxamine.

Topics: Amitriptyline; Animals; Antidepressive Agents; Desipramine; Disease Models, Animal; Dose-Response Relationship, Drug; Electroencephalography; Epilepsy; Fluvoxamine; Imipramine; Male; Maprotiline; Mianserin; Oximes; Rats; Rats, Inbred Strains; Seizures; Viloxazine