Reactions 919 - 14 Sep 2002

SCitalopram

Nonconvulsive status epilepticus in an elderlystroke patient: case report

Citalopram therapy for depression was associated withnonconvulsive status epilepticus in a 73-year-old woman witha recent history of stroke; she had no previous history ofseizures.

Two months after the woman’s stroke occurred, she beganreceiving citalopram 20 mg/day for depression. Five days afterstarting citalopram, she developed prolonged convulsions ofher left arm associated with reduced consciousness. Sheinitially responded to treatment with IV clonazepam, followedby IV sodium valproate. However, her reduced consciousnesspersisted. An EEG revealed diffuse slow-wave activity in theright frontal lobe, indicating partial nonconvulsive statusepilepticus.

The woman continued IV sodium valproate therapy and wasgiven a single dose of IV phenytoin. Citalopram wasdiscontinued. A repeat EEG showed only sporadic epileptiformactivity. At follow-up 2 weeks later, another EEG showed noevidence of epileptic discharges.

Author comment: ‘Citalopram probably played a major rolein provoking the epileptic activity.’Hagebeuk EEO, et al. A stroke patient with a non-convulsive status epilepticusduring citalopram therapy. European Journal of Neurology 9: 319-320, May 2002 -Netherlands 807209585

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Reactions 14 Sep 2002 No. 9190114-9954/10/0919-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved