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What Causes Seizures When On Celexa?

Posted on Sat, 17 May 2014

Question: Son was on Celexa for approx. 15 years ...total care 24/7 but has a little behavioral issue that nuero thought would correct. Son is 29 with brain function of 2 yr old. In 2012 he all of sudden had a grand mals seizure and coded and I had to start CPR. Transported to ER an admitted. Did a EEG negative for seizures. Then in Aug 2012 again same thing happened and he stopped breathing and blue and got to floor out of his wheelchair and was able to get him breathing with out CPR. Third time was Dec 2012 same thing. He was on Kepra and then switched to Depakote and then to Valporic Acid and now to Lamictol. The grand mals have recently in Nov 2013 traced to Celexa. It was withdrawn while in hospital. While hospitalized he was taken off the Celexa and now five months later he has another episode stopped breathing and turns blue. Since he is not having seizures and EEG five times in two years and negative everytime why would they keep him on the Lamictol? I believe they should be withdrawl of the Lamictol since no seizures and according to FDA and manufactors website this could cause seizures if your not having any.

My question is : No seizure activity but on seizure meds.... Celexa caused the previous grand mals (3 times) and no more seizures since removed. Why would you keep him on that dreadful medicine? What could be causing the turning blue and stop breathing without warning? He turns head to right and like it freezes there and cut off his air supply. No one here in Tampa Fl can seem to figure this out.

I am in the process of taking him to XXXXXXX XXXXXXX for a eval to find the answers.
Can you or anyone here help me understand what is going on? Am I doing the right thing taking him to XXXXXXX Hopkins?

Answered by Dr. Sudhir Kumar (7 hours later)

Brief Answer:
Possibilities include syncope and seizures

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your son's details and I can understand your dilemma, as no clear cut diagnosis has yet been made.

Regarding his episodes, there are two main diagnostic possibilities:

1. Cardiac- where the blood supply to brain is reduced to the brain due to poor pumping of blood by the heart. This is referred to as syncope. In a young person, the underlying cause could be cardiac arrhythmia (an abnormality of heart rhythm).

2. Neurological- seizures. EEG may come as normal in patients with seizures, as the abnormal electrical discharges in the brain are episodic and not continuous.

Regarding discontinuation of anti-epileptic drug, the dilemma is that we are not sure whether he has seizures or not (as EEG being negative does not rule out seizures).

Further investigations that could help sort out the diagnosis are:

1. Holter monitoring of heart to look for any cardiac arrhythmia

2. Long-term video EEG monitoring may help in picking up abnormal electrical discharges in the brain,

3. PET scan of the brain- may also help to diagnose epileptiform discharges.

I hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (2 hours later)

Pulm eval was neg ...cardio ultra sound neg. Holter monitor for 7 days. One thing was low oxygen levels while lying down one night. Level ranged from 95 and few times 82. Alarm went off several times that night. But still discharged next day. This time EEG was 48 hours. Last time each was 5-7 days long term and negative. One episode and several months before next one. But now its three in two weeks. Any other suggestion? Eval at XXXXXXX XXXXXXX epilespy hospital is next if we can get appt? Live in fl awaiting opening. Its in maryland.

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer:
Johns XXXXXXX is the best option.

Detailed Answer:
Thank you for getting back and providing more information.

Your son has had a fairly good diagnostic work up.

Cardiac electrophysiology (EP studies) would be one of the studies that could be done to evaluate the heart function better.

Johns XXXXXXX evaluation is the best option at this stage.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (14 hours later)

We got all his medical records sent to XXXXXXX XXXXXXX hospital today from hospital and yesterday all 5 doctors offices. We stopped using lots of mayo in his meals and he seems to be a little better. He has less tremors and better bowel movement too. Could this be gastro problems to? We're awaiting the call from XXXXXXX XXXXXXX Do we ask for several specialist or go with the epilepsy dept only first and rule that out? Then request the doctor refer us to different doctors? Do you have any special questions I should be asking these doctors that I would not know to ask? I questioned about the EP study but cardio dr doesn't do that. Was told to have it completed at XXXXXXX

Answered by Dr. Sudhir Kumar (4 hours later)

Brief Answer:
Unlikely to be a gastro problem

Detailed Answer:
Thank you for getting back and providing more information.

I am glad to note his mild improvement.

It does not seem to be a gastro problem.

It would be better to go first for epilepsy evaluation and then get referred to other doctors, if epilepsy is ruled out.

You should get the EP studies also done at XXXXXXX

No other questions/issues that I can think of at this moment.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar