Journal
NEUROLOGY
Volume 75, Issue 13, Pages 1166-1173Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e3181f4d5a9
Keywords
-
Categories
Funding
- NIH/NINDS [5K23 NS045902, 5K23NS45902 [PI]]
- Rhode Island Hospital
- American Epilepsy Society
- Epilepsy Foundation
- Siravo Foundation
- NIH [R01AG016335, P50CA84719, R01DA019558, R01DA018079, R01HL064342, R01MH079153, R01NR010559, R01AA016799, R21CA137211, R01CA132854, U01CA150387-0, 5P20 RR024484, 5R01CA123544, 5U19AI070202]
- American Legacy Foundation
- Miriam and Rhode Island Hospitals
- UCB
- Eisai Inc.
- NIAMS 01A2 [1R01-AR056834, 1R01 AR056834-01S1, 1R01AA017895-01A2]
- Firan Foundation
- NIH (NIMH) [NIMH R34 MH070743-01, NIMH R34 MH078855 [PI], NIMH R01 MH071766]
- NIAAA [R01 AA015950 [PI]]
- NIMH [R34 MH073625 [PI], NIMH R34MH079108, NIMH R34MH083065-01, NIMH U01MH088278 [Co-PI], NIMH R34MH08221]
- NIDA [R01DA023190]
- [R01DA023072]
Ask authors/readers for more resources
Objective: There have been few treatment trials for psychogenic nonepileptic seizures (PNES). Some psychotherapies have been shown to improve PNES and comorbid symptom outcomes. We evaluated a pharmacologic intervention to test the hypothesis that sertraline would reduce PNES. Methods: We conducted a pilot, double-blind, randomized, placebo-controlled trial in an academic medical hospital with epilepsy center outpatients. Subjects aged 18 to 65 years diagnosed with video-EEG-confirmed PNES were treated with flexible-dose sertraline or placebo over 12 weeks. Seizure calendars and symptom scales were charted prospectively. Secondary outcome measures included psychiatric symptom scales and psychosocial variables. Results: Thirty-eight subjects enrolled, and 26 (68%) completed the trial. Thirty-three subjects with nonzero nonepileptic seizure rates at baseline were included in intent-to-treat analysis of the primary outcome. Subjects assigned to the sertraline arm experienced a45% reduction in seizure rates from baseline to final visit (p = 0.03) vs an 8% increase in placebo (p = 0.78). Secondary outcome scales revealed no significant between-group differences in change scores from baseline to final visit, after adjustment for differences at baseline. Conclusions: PNES were reduced in patients treated with a serotonin selective reuptake inhibitor, whereas those treated with placebo slightly increased. This study provides feasibility data for a larger-scale study. Level of evidence: This study provides Class II evidence that flexible-dose sertraline up to a maximum dose of 200 mg is associated with a nonsignificant reduction in PNES rate compared with a placebo control arm (risk ratio 0.51, 95% confidence interval 0.25-1.05, p = 0.29), adjusting for differences at baseline. Neurology (R) 2010; 75: 1166-1173
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available