Primär fokale, sekundär generalisierte epileptische Anfälle unter Paroxetin

We report on a 73-year old man with major depression. During therapy with paroxetine, a potent serotonine reuptake inhibitor (SSRI) the patient developed two secondary generalised seizures. After paroxetine was stopped and benzodiazepines were started the EEG showed a bio-electric status epilepticus. The status ceased when therapy with valproic acid was initiated. Cranial MRI showed multiple lacunar infarctions. We conclude that patients receiving SSRI are prone to epileptic seizures, particulary if focal brain lesions are preexistent.