Does Sertraline lower the seizure threshold? (3 risk groups)
In this article, we will answer the question, “Does Sertraline lower seizure threshold?”. We will also discuss what factors increase the risk of seizures with Sertraline use and what precautions should be kept in mind for the safe use of Sertraline.
Does Sertraline lower the seizure threshold?
Yes, Sertraline can lower the seizure threshold but the risk is relatively low as compared to other antidepressant medications.
Many antidepressants share the characteristic of potentially reducing the seizure threshold but Selective Serotonin Reuptake Inhibitors (SSRIs) such as Sertraline are generally considered a safer choice. (1) (2)
Seizures are prevalent and commonly encountered hallmarks of epilepsy and it is quite common to find comorbid depressive disorders as well. In such cases, the beneficial effect of Sertraline in treating depression outweighs the relatively slight risk of lowering the seizure threshold. (2)
How safe is Sertraline for people with epilepsy and seizures?
As stated earlier, people with epilepsy often suffer from mood and anxiety disorders which significantly impact their quality of life. Sertraline is frequently the choice of drug for managing these conditions safely.
A study suggests that there is a possibility of Sertraline, provoking epileptic seizures in only 0.1 to 1.5% of patients approximately. This indicates that at lower doses Sertraline does not tend to provoke or worsen seizure. (3) (4)
Another study supports the idea that Sertraline is a safe and effective option for treating depression in people with seizures or epilepsy. It is particularly safe when used at lower doses and reduces brain inflammation, promoting overall well-being. (5)
Who is more susceptible to seizures while taking Sertraline?
While studies have indicated that Sertraline has a lower risk of seizures, some people are more susceptible to it. These include:
- People with a history of pre-existing seizures or epilepsy.
- People who are using higher doses of Sertraline for a long time.
- Those who initiate Sertraline therapy at higher doses without titration.
- Individuals with a history of substance abuse or alcohol use alongside Sertraline.
- People suffering from certain underlying conditions such as Sertraline deficiency or Serotonin Syndrome. (4)
What are the potential symptoms of seizures if using Sertraline?
A higher dosage of Sertraline can potentiate the risk of causing seizures so it is essential to be well-informed about signs and symptoms of seizures.
Seizures are a serious medical emergency and having proper knowledge about their symptoms can be invaluable for timely intervention and support.
Here are some major signs of seizures; (6)
- Sudden, uncontrolled jerking or twitching of muscles
- Complete loss of awareness and consciousness
- Altered sensory experiences such as unusual smell, taste or visual distortions
- Blank stares or periods of unresponsiveness
- Sudden emotional changes such as intense fear or anxiety
- Loss of bladder or bowel control
- Difficulty speaking or slurred speech
- Tonic-clonic movements
What to do if Sertraline causes seizures?
If you experience seizures due to Sertraline, seeking immediate medical attention is crucial. Here is what you should do:
- Contact your healthcare provider promptly for guidance.
- Your healthcare provider may adjust the dosage of Sertraine as needed to manage your condition or suggest alternative medicines.
- Your healthcare provider may prescribe you an anticonvulsant medication to help control seizures.
- Attend all follow-up appointments to properly monitor your condition.
How to use Sertraline safely?
Let’s explore some tips to ensure the safe use of Sertraline and to get maximum benefit from this treatment.
- Always adhere to your doctor’s precise instructions when taking Sertraline
- Discuss with your doctor to start Sertraline with a low dose and then gradually increase it.
- Before initiating Sertraline, inform your doctor if you have a history of seizures or epilepsy.
- Avoid discontinuing Sertraline abruptly to prevent potential withdrawal effects.
- Always take Sertraline at the same time every day to maintain a uniform therapeutic effect on the body.
In conclusion, we have explored the impact of Sertraline on seizure threshold, highlighting its relatively low risk as compared to the other antidepressants.
It is essential to acknowledge that Sertraline is often a valuable treatment option for people with seizures, epilepsy and concurrent depressive disorders.
Sertraline when used cautiously, can provide significant benefits in managing mood disorders in the context of epilepsy. Make sure to consult with your healthcare provider to ensure a safe and tailored plan.
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Giorgio Magli, Marta Conti, Roberto Polano, Giovanni Luzzu, Maria Fadda, Stefano Sotgiu, Susanna Casellato, Seizures associated with selective serotonin reuptake inhibitors: A case of pharmacologically induced epileptic myoclonia, Seizure, Volume 88, 2021, Pages 75-77, ISSN 1059-1311, https://doi.org/10.1016/j.seizure.2021.03.031.
Sarkar S, Search for more papers by this author, Gangadhar S, Subramaniam E, Praharaj SK, Psychiatry Dept of, et al. Seizure with sertraline: Is there a risk? [Internet]. 2014 [cited 2023 Sept 27]. Available from: https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.13070146
LaFrance, W., Keitner, G., Papandonatos, G., Blum, A., Machan, J., Ryan, C., & Miller, I. (2010). Pilot pharmacologic randomized controlled trial for psychogenic nonepileptic seizures. Neurology, 75, 1166 – 1173.