Seizures associated with therapeutic doses of venlafaxine and trimipramine
OBJECTIVE: To report a patient having a first-time seizure after receiving venlafaxine and trimipramine for depression. CASE SUMMARY: A 25-year-old white woman with chronic depression was treated with venlafaxine 150 mg/d and trimipramine 50 mg/d. Eleven days after increase of the trimipramine dosag...
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| Veröffentlicht in: | The Annals of pharmacotherapy 2000-12, Vol.34 (12), p.1402-1405 |
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| container_title | The Annals of pharmacotherapy |
| container_volume | 34 |
| creator | Schlienger, RG Klink, MH Eggenberger, C Drewe, J |
| description | OBJECTIVE:
To report a patient having a first-time seizure after receiving venlafaxine and trimipramine for depression.
CASE SUMMARY:
A 25-year-old white woman with chronic depression was treated with venlafaxine 150 mg/d and trimipramine 50 mg/d. Eleven days after increase of the trimipramine dosage to 100 mg/d, she was hospitalized because of seizures suggesting a secondary generalized grandmal episode. The electroencephalogram showed a pathologic pattern with several generalized epileptiform discharges. Because of suspected drug-induced seizures, both antidepressants were stopped. After antidepressant drug cessation, the patient was symptom free and had no further seizure episodes within the following 12 months of follow-up. No other potential cause for the seizure episode could be identified.
DISCUSSION:
Both venlafaxine and trimipramine have been associated with seizures, mainly after overdose. Venlafaxine-associated seizures at therapeutic doses have not been reported in the literature. We hypothesize that a pharmacodynamic or pharmacokinetic drug interaction between venlafaxine and trimipramine involving the CYP2D6 isoenzyme may have played a role in inducing the seizures.
CONCLUSIONS:
Clinicians should be aware of the proepileptogenic effect of venlafaxine and trimipramine at therapeutic doses and that this combination may eventually increase the risk of seizures. |
| doi_str_mv | 10.1345/aph.10050 |
| format | Article |
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To report a patient having a first-time seizure after receiving venlafaxine and trimipramine for depression.
CASE SUMMARY:
A 25-year-old white woman with chronic depression was treated with venlafaxine 150 mg/d and trimipramine 50 mg/d. Eleven days after increase of the trimipramine dosage to 100 mg/d, she was hospitalized because of seizures suggesting a secondary generalized grandmal episode. The electroencephalogram showed a pathologic pattern with several generalized epileptiform discharges. Because of suspected drug-induced seizures, both antidepressants were stopped. After antidepressant drug cessation, the patient was symptom free and had no further seizure episodes within the following 12 months of follow-up. No other potential cause for the seizure episode could be identified.
DISCUSSION:
Both venlafaxine and trimipramine have been associated with seizures, mainly after overdose. Venlafaxine-associated seizures at therapeutic doses have not been reported in the literature. We hypothesize that a pharmacodynamic or pharmacokinetic drug interaction between venlafaxine and trimipramine involving the CYP2D6 isoenzyme may have played a role in inducing the seizures.
CONCLUSIONS:
Clinicians should be aware of the proepileptogenic effect of venlafaxine and trimipramine at therapeutic doses and that this combination may eventually increase the risk of seizures.</description><identifier>ISSN: 1060-0280</identifier><identifier>EISSN: 1542-6270</identifier><identifier>DOI: 10.1345/aph.10050</identifier><identifier>PMID: 11144696</identifier><identifier>CODEN: APHRER</identifier><language>eng</language><publisher>Cincinnati, OH: Harvey Whitney Books</publisher><subject>Antidepressive Agents, Second-Generation - administration & dosage ; Antidepressive Agents, Second-Generation - adverse effects ; Antidepressive Agents, Tricyclic - administration & dosage ; Antidepressive Agents, Tricyclic - adverse effects ; Biological and medical sciences ; Cyclohexanols - administration & dosage ; Cyclohexanols - adverse effects ; Drug Interactions ; Drug toxicity and drugs side effects treatment ; Female ; Humans ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Seizures - chemically induced ; Toxicity: nervous system and muscle ; Trimipramine - administration & dosage ; Trimipramine - adverse effects ; Venlafaxine Hydrochloride</subject><ispartof>The Annals of pharmacotherapy, 2000-12, Vol.34 (12), p.1402-1405</ispartof><rights>2000 SAGE Publications</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-117ff5ecd60894c71f207fb63a649cbb4bbb855921cb5751105c7e89d6a03aec3</citedby><cites>FETCH-LOGICAL-c372t-117ff5ecd60894c71f207fb63a649cbb4bbb855921cb5751105c7e89d6a03aec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1345/aph.10050$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1345/aph.10050$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21818,27923,27924,43620,43621</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=831895$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11144696$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schlienger, RG</creatorcontrib><creatorcontrib>Klink, MH</creatorcontrib><creatorcontrib>Eggenberger, C</creatorcontrib><creatorcontrib>Drewe, J</creatorcontrib><title>Seizures associated with therapeutic doses of venlafaxine and trimipramine</title><title>The Annals of pharmacotherapy</title><addtitle>Ann Pharmacother</addtitle><description>OBJECTIVE:
To report a patient having a first-time seizure after receiving venlafaxine and trimipramine for depression.
CASE SUMMARY:
A 25-year-old white woman with chronic depression was treated with venlafaxine 150 mg/d and trimipramine 50 mg/d. Eleven days after increase of the trimipramine dosage to 100 mg/d, she was hospitalized because of seizures suggesting a secondary generalized grandmal episode. The electroencephalogram showed a pathologic pattern with several generalized epileptiform discharges. Because of suspected drug-induced seizures, both antidepressants were stopped. After antidepressant drug cessation, the patient was symptom free and had no further seizure episodes within the following 12 months of follow-up. No other potential cause for the seizure episode could be identified.
DISCUSSION:
Both venlafaxine and trimipramine have been associated with seizures, mainly after overdose. Venlafaxine-associated seizures at therapeutic doses have not been reported in the literature. We hypothesize that a pharmacodynamic or pharmacokinetic drug interaction between venlafaxine and trimipramine involving the CYP2D6 isoenzyme may have played a role in inducing the seizures.
CONCLUSIONS:
Clinicians should be aware of the proepileptogenic effect of venlafaxine and trimipramine at therapeutic doses and that this combination may eventually increase the risk of seizures.</description><subject>Antidepressive Agents, Second-Generation - administration & dosage</subject><subject>Antidepressive Agents, Second-Generation - adverse effects</subject><subject>Antidepressive Agents, Tricyclic - administration & dosage</subject><subject>Antidepressive Agents, Tricyclic - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Cyclohexanols - administration & dosage</subject><subject>Cyclohexanols - adverse effects</subject><subject>Drug Interactions</subject><subject>Drug toxicity and drugs side effects treatment</subject><subject>Female</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Seizures - chemically induced</subject><subject>Toxicity: nervous system and muscle</subject><subject>Trimipramine - administration & dosage</subject><subject>Trimipramine - adverse effects</subject><subject>Venlafaxine Hydrochloride</subject><issn>1060-0280</issn><issn>1542-6270</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0Etr3DAQB3BRGrpJ2kO_QDAUGnJwOiNLfhzDkkdDIIekZzGWpViL1zaSHTf59FG7S3PpSYP4MY8_Y18RzjET8geN7TkCSPjADlEKnua8gI-xhhxS4CWs2FEIGwCokFef2AoRhcir_JDdPhj3OnsTEgph0I4m0ySLm9pkao2n0cyT00kzhCgGmzybviNLv11vEuqbZPJu60ZP2_jxmR1Y6oL5sn-P2a-ry8f1TXp3f_1zfXGX6qzgU4pYWCuNbnIoK6ELtBwKW-cZ5aLSdS3qui6lrDjqWhYSEaQuTFk1OUFGRmfH7GzXV_shBG-sGuMW5F8UgvqTh4p5qL95RHuys-Ncb03zLvcBRPBtDyho6qynXrvwz5UZlpWM6vtOBXoyajPMvo8X_nfe6Q627qldnDcqbKnr4nRUy7JkQiFXKIBnb8Kbgjs</recordid><startdate>20001201</startdate><enddate>20001201</enddate><creator>Schlienger, RG</creator><creator>Klink, MH</creator><creator>Eggenberger, C</creator><creator>Drewe, J</creator><general>Harvey Whitney Books</general><general>SAGE Publications</general><general>Whitney</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20001201</creationdate><title>Seizures associated with therapeutic doses of venlafaxine and trimipramine</title><author>Schlienger, RG ; Klink, MH ; Eggenberger, C ; Drewe, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-117ff5ecd60894c71f207fb63a649cbb4bbb855921cb5751105c7e89d6a03aec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Antidepressive Agents, Second-Generation - administration & dosage</topic><topic>Antidepressive Agents, Second-Generation - adverse effects</topic><topic>Antidepressive Agents, Tricyclic - administration & dosage</topic><topic>Antidepressive Agents, Tricyclic - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Cyclohexanols - administration & dosage</topic><topic>Cyclohexanols - adverse effects</topic><topic>Drug Interactions</topic><topic>Drug toxicity and drugs side effects treatment</topic><topic>Female</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Seizures - chemically induced</topic><topic>Toxicity: nervous system and muscle</topic><topic>Trimipramine - administration & dosage</topic><topic>Trimipramine - adverse effects</topic><topic>Venlafaxine Hydrochloride</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schlienger, RG</creatorcontrib><creatorcontrib>Klink, MH</creatorcontrib><creatorcontrib>Eggenberger, C</creatorcontrib><creatorcontrib>Drewe, J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>The Annals of pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schlienger, RG</au><au>Klink, MH</au><au>Eggenberger, C</au><au>Drewe, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Seizures associated with therapeutic doses of venlafaxine and trimipramine</atitle><jtitle>The Annals of pharmacotherapy</jtitle><addtitle>Ann Pharmacother</addtitle><date>2000-12-01</date><risdate>2000</risdate><volume>34</volume><issue>12</issue><spage>1402</spage><epage>1405</epage><pages>1402-1405</pages><issn>1060-0280</issn><eissn>1542-6270</eissn><coden>APHRER</coden><abstract>OBJECTIVE:
To report a patient having a first-time seizure after receiving venlafaxine and trimipramine for depression.
CASE SUMMARY:
A 25-year-old white woman with chronic depression was treated with venlafaxine 150 mg/d and trimipramine 50 mg/d. Eleven days after increase of the trimipramine dosage to 100 mg/d, she was hospitalized because of seizures suggesting a secondary generalized grandmal episode. The electroencephalogram showed a pathologic pattern with several generalized epileptiform discharges. Because of suspected drug-induced seizures, both antidepressants were stopped. After antidepressant drug cessation, the patient was symptom free and had no further seizure episodes within the following 12 months of follow-up. No other potential cause for the seizure episode could be identified.
DISCUSSION:
Both venlafaxine and trimipramine have been associated with seizures, mainly after overdose. Venlafaxine-associated seizures at therapeutic doses have not been reported in the literature. We hypothesize that a pharmacodynamic or pharmacokinetic drug interaction between venlafaxine and trimipramine involving the CYP2D6 isoenzyme may have played a role in inducing the seizures.
CONCLUSIONS:
Clinicians should be aware of the proepileptogenic effect of venlafaxine and trimipramine at therapeutic doses and that this combination may eventually increase the risk of seizures.</abstract><cop>Cincinnati, OH</cop><pub>Harvey Whitney Books</pub><pmid>11144696</pmid><doi>10.1345/aph.10050</doi><tpages>4</tpages></addata></record> |
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| ispartof | The Annals of pharmacotherapy, 2000-12, Vol.34 (12), p.1402-1405 |
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| language | eng |
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| source | MEDLINE; SAGE Complete A-Z List |
| subjects | Antidepressive Agents, Second-Generation - administration & dosage Antidepressive Agents, Second-Generation - adverse effects Antidepressive Agents, Tricyclic - administration & dosage Antidepressive Agents, Tricyclic - adverse effects Biological and medical sciences Cyclohexanols - administration & dosage Cyclohexanols - adverse effects Drug Interactions Drug toxicity and drugs side effects treatment Female Humans Medical sciences Middle Aged Pharmacology. Drug treatments Seizures - chemically induced Toxicity: nervous system and muscle Trimipramine - administration & dosage Trimipramine - adverse effects Venlafaxine Hydrochloride |
| title | Seizures associated with therapeutic doses of venlafaxine and trimipramine |
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