Seizure reduction with fluoxetine in an adult woman with Dravet syndrome

An adult woman with Dravet syndrome (documented SCN1A mutation) experienced a marked reduction in seizures when treated with the selective serotonin reuptake inhibitor (SSRI) fluoxetine. The seizure reduction may be partly due to reductions associated with aging in patients with Dravet syndrome, but it appears to be due, at least in part, to fluoxetine. A prior preliminary study reported that fenfluramine reduces seizures in patients with Dravet syndrome. Fenfluramine may produce this effect by increasing serotonin brain levels, and SSRIs have been found to possess antiepileptic properties in animal models of epilepsy. Given the known cardiac risks of fenfluramine, randomized clinical trials with SSRIs should be considered in Dravet syndrome and other types of epilepsy.