Brief Answer:
Evidence for Zoloft, not enough for Mirapex.

Detailed Answer:
Hello and thank you for returning to HealthcareMagic for your health related questions.

1. All antidepressants have been shown to have an effect on seizures. Not all at the same degree though. Zoloft is recommended as among the safest ones on that regard, if necessary it's use is not contraindicated. If you mean concrete evidence I would site the WHO (world health organization) adverse drug reactions database a review of which found reports of suspected seizures in 3.23% of patients on sertraline (Zoloft). Remember that that number is high as it includes all suspected reports. Other studies which follow patients closely find an increase of incidence of seizures of about 0.2%. So the risk increase is quite small.

WHO database review link:
http://www.seizure-journal.com/article/S1059-1311(09)00233-7/fulltext

2. There have been some published trials of the use of Mirapex in treatment resistant depression which have shown it to be effective in high doses. However they are studies with low numbers of patients. Much larger trials are needed to confirm results, so while they do support that hypothesis I wouldn't consider them evidence, more like a starting point for future trials.

Links to articles:
http://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2015.0000
http://onlinelibrary.wiley.com/doi/10.1002/da.20038/abstract;jsessionid=02B2025EA3A085A2B6A4D2F03B828E52.f03t01

I remain at your disposal for other questions.

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Brief Answer:
Read below.

Detailed Answer:
Thank you for that articles. It is a good study published in a serious journal. I suppose you mean page 6. There is not much about sertraline on page 8, apart from a table which actually shows an increased hazard ratio at 1.71.

I do not see the study to be much of a contradiction really. It is common for epidemiological studies to show variations among them. When it comes to such low figures (in my answer I said the risk increase to be usually reported at an average of 0.2%) it is not strange that while some studies may show slightly higher figures, while others like this one slightly lower ones, which for such low percentages may fall below the threshold for statistical significance. Variations are also due to methods used, patients and dosages included, statistical definitions and tools employed. In this study for example only patients aged 20-64 have been included, if older patients were included as well might have had slightly different figures. If you see on page 10 there are comparisons with other studies where many contradictions are listed, as I said variations are common, that is why one single study is never considered enough in medicine, many studies and clinical trials are conducted on the same subject.

From a practical point of view what matters when making clinical decisions is that sertraline remains between different studies one of the safest ones to use when seizure risk is considered.

Let me know if I can further assist you.

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