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Summary

There are no simple answers to questions such as ‘Which antidepressant is most likely to cause seizures?’ or ‘Which antipsychotic drug is the safest to use in a patient with a seizure disorder?’

The risk of psychotropic drug-induced seizures is dependent on many factors beyond inherent differences in the propensity of individual drugs to lower seizure threshold. Individual patient variables that affect the likelihood of drug-induced seizures occurring include a history of epilepsy or seizures, a family history of epilepsy, and postnatal brain damage, head trauma and dementia. Once a drug is selected, seizure risk is directly dependent on dosage, rate and amount of dose titration, and concurrent use of other drugs.

Setting aside these other risk factors, the likelihood of drug-induced seizures occurring does differ among psychotropic drugs. Among antipsychotic drugs, clozapine is …