Bupropion is commonly associated with lowering of the seizure threshold. This effect appears to be dose-related and can potentially be avoided if the dose is titrated slowly and does not exceed 450 mg/day. If possible bupropion should be avoided in patients with a known diagnosis of epilepsy. Tricyclic antidepressants (TCAs), at supratherapeutic doses can induce seizures. TCAs can block GABA A receptors and decrease inhibitory neuronal signals, resulting in seizures.3 Caution should be exercised when using these medications in patients who may be at a high risk of developing seizures or have a known diagnosis of epilepsy. If TCAs are prescribed they should be titrated slowly and patients should be monitored for adverse events. A rare side effect of selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) is serotonin syndrome, which can lead to seizures in 1–2 % of affected patients, and is extremely rare.4 Use of SSRIs and SNRIs should not be withheld in patients with epilepsy.