The association of serotonin reuptake inhibitors and benzodiazepines with ictal central apnea

Autor: Rita Martins, Lisa M. Bateman, Norma J. Hupp, M. R. Sandhya Rani, Ronald M. Harper, Rup K. Sainju, Jaison S. Hampson, Catherine Scott, Luke A. Allen, Kingman P. Strohl, Daniel Friedman, Jennifer A. Ogren, Orrin Devinsky, Beate Diehl, Samden D. Lhatoo, Anita Zaremba, Brian K. Gehlbach, Laura Vilella, Johnson P. Hampson, Nuria Lacuey, Stephan U. Schuele, George B. Richerson, Maromi Nei
Rok vydání: 2019
Předmět:
Serotonin reuptake inhibitors
Male
SUDEP
Central apnea
Neurodegenerative
Electroencephalography
Hypoxemia
Cohort Studies
Behavioral Neuroscience
Epilepsy
Benzodiazepines
0302 clinical medicine
030212 general & internal medicine
Oximetry
Prospective Studies
Sudden Unexpected Death in Epilepsy
Hypoxia
Lung
Central
medicine.diagnostic_test
Ictal central apnea
Middle Aged
Sleep Apnea
Central
Neurology
Anesthesia
Neurological
Breathing
Serotonin Uptake Inhibitors
Female
medicine.symptom
Selective Serotonin Reuptake Inhibitors
Adult
Sleep Apnea
Adolescent
Clinical Sciences
Article
03 medical and health sciences
Young Adult
Clinical Research
Seizures
medicine
Humans
Ictal
Aged
Neurology & Neurosurgery
business.industry
Neurosciences
medicine.disease
Brain Disorders
Pulse oximetry
Good Health and Well Being
Relative risk
Neurology (clinical)
business
030217 neurology & neurosurgery
Zdroj: Epilepsy Behav
Epilepsy & behavior : E&B, vol 98, iss Pt A
ISSN: 1525-5069
Popis: Objective 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. Methods 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. Results 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). Conclusions 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.
Databáze: OpenAIRE
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