Recurrence of absence seizures induced by a low dose of amitriptyline: A case report

We report a case of recurrence of absence seizures possibly induced by low doses of amitriptyline. A patient with juvenile absence epilepsy on chronic valproic acid monotherapy and seizure-free for a period of 6 years experienced a recurrence of absence seizures on starting a headache prophylaxis with a low dose of amitriptyline (0.3 mg/kg). Seizures disappeared immediately after the addition of ethosuximide to antiepileptic therapy in spite of continuing amitriptyline. After stopping amitriptyline (3 months later) ethosuximide was also stopped and the patient remained, as before, seizure-free on valproic acid monotherapy.