Worsening of myasthenia due to antiepileptic, antipsychotic, antidepressant, and sedative medication: An estimation of risk based on reporting frequency

Background and purpose Many drugs can worsen myasthenia symptoms. The clinician usually relies on cautionary lists compiled according to case reports. We intended provide a quantitative basis for risk comparison within the groups of antiepileptic, antidepressant, neuroleptic, sedative drugs. Methods extracted adverse drug reaction (ADR) counts (total related) from these calculated reporting odds ratio (ROR) World Health Organization pharmacovigilance database. For given drug, ROR was increased above 1 if proportion myasthenia-related ADRs this larger than same rest in that group. If 95% confidence interval >1, taken as signal higher compared average respective Results Gabapentin, sertraline, citalopram, lithium, amisulpride had be their groups. Bupropion, desvenlafaxine, duloxetine, escitalopram, paroxetine values <1. all other drugs, interval. Conclusions gabapentin analysis RORs confirmed reports lists. number antidepressant associated with higher-than-average risk, no exist substantiating our results. special attention should paid risk. remarkable difference between citalopram escitalopram could prompt experimental work confirm differential influence two preparations neuromuscular transmission.