The association of serotonin reuptake inhibitors and benzodiazepines with ictal central apnea.
Adolescent
Adult
Aged
Benzodiazepines
/ therapeutic use
Cohort Studies
Electroencephalography
/ methods
Epilepsy
/ drug therapy
Female
Humans
Hypoxia
/ drug therapy
Male
Middle Aged
Oximetry
/ methods
Prospective Studies
Seizures
/ drug therapy
Selective Serotonin Reuptake Inhibitors
/ therapeutic use
Sleep Apnea, Central
/ drug therapy
Sudden Unexpected Death in Epilepsy
/ prevention & control
Young Adult
Benzodiazepines
Ictal central apnea
SUDEP
Seizures
Serotonin reuptake inhibitors
Journal
Epilepsy & behavior : E&B
ISSN: 1525-5069
Titre abrégé: Epilepsy Behav
Pays: United States
ID NLM: 100892858
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
08
04
2019
revised:
14
06
2019
accepted:
15
06
2019
pubmed:
14
7
2019
medline:
8
7
2020
entrez:
14
7
2019
Statut:
ppublish
Résumé
Ictal (ICA) and postconvulsive central apnea (PCCA) have been implicated in sudden unexpected death in epilepsy (SUDEP) pathomechanisms. Previous studies suggest that serotonin reuptake inhibitors (SRIs) and benzodiazepines (BZDs) may influence breathing. The aim of this study was to investigate if chronic use of these drugs alters central apnea occurrence in patients with epilepsy. Patients with epilepsy admitted to epilepsy monitoring units (EMUs) in nine centers participating in a SUDEP study were consented. Polygraphic physiological parameters were analyzed, including video-electroencephalography (VEEG), thoracoabdominal excursions, and pulse oximetry. Outpatient medication details were collected. Patients and seizures were divided into SRI, BZD, and control (no SRI or BZD) groups. Ictal central apnea and PCCA, hypoxemia, and electroclinical features were assessed for each group. Four hundred and seventy-six seizures were analyzed (204 patients). The relative risk (RR) for ICA in the SRI group was half that of the control group (p = 0.02). In the BZD group, ICA duration was significantly shorter than in the control group (p = 0.02), as was postictal generalized EEG suppression (PGES) duration (p = 0.021). Both SRI and BZD groups were associated with smaller seizure-associated oxygen desaturation (p = 0.009; p ≪ 0.001). Neither presence nor duration of PCCA was significantly associated with SRI or BZD (p ≫ 0.05). Seizures in patients taking SRIs have lower occurrence of ICA, and patients on chronic treatment with BZDs have shorter ICA and PGES durations. Preventing or shortening ICA duration by using SRIs and/or BZD in patients with epilepsy may play a possible role in SUDEP risk reduction.
Identifiants
pubmed: 31301453
pii: S1525-5050(19)30335-X
doi: 10.1016/j.yebeh.2019.06.029
pmc: PMC8975169
mid: NIHMS1532562
pii:
doi:
Substances chimiques
Serotonin Uptake Inhibitors
0
Benzodiazepines
12794-10-4
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
73-79Subventions
Organisme : NINDS NIH HHS
ID : U01 NS090405
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS090407
Pays : United States
Organisme : NINDS NIH HHS
ID : U01 NS090414
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
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