ArticleEpilepsy & behavior : E&B2019
The association of serotonin reuptake inhibitors and benzodiazepines with ictal central apnea.
Article in Epilepsy & behavior : E&B, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 35 citations in OpenAlex.
- Use of Fluoxetine to Augment the Inter-Ictal Hypercapnic Ventilatory Response in Patients with Epilepsy: A Pilot Study.Neurology IndiaTrial
- Severe, Non-apneic Respiratory Dysfunction and Hypoxia following Generalized Convulsive Seizures.Annals of neurology · 2026Article
- Serotonin Associated Mechanisms in Sudden Unexpected Death in Epilepsy: A Review.Revista de neurologia · 2026Review
- Respiratory dysfunction and fatal apnea during pilocarpine-induced status epilepticus.Epilepsia · 2026Article
- The bed nucleus of the stria terminalis as a neuromodulatory target for refractory epilepsy.Frontiers in network physiology · 2026Review
- Plasticity induced loss of apnea alarm through repeated apneas: A proposed mechanism for respiratory sudden death.Epilepsy & behavior : E&B · 2025Review
- Sudden Unexpected Death in Epilepsy: Central Respiratory Chemoreception.International journal of molecular sciences · 2025Review
- Enhancing the action of serotonin by three different mechanisms prevents spontaneous seizure-induced mortality in Dravet mice.Epilepsia · 2024Article
- 5-HT receptors exert differential effects on seizure-induced respiratory arrest in DBA/1 mice.PloS one · 2024Article
- Sudden death in epilepsy: the overlap between cardiac and neurological factors.Brain communications · 2024Review
- Can intravenous lorazepam prevent postictal generalized EEG suppression? A case report.Clinical neurophysiology practice · 2024Article
- Article
- Interictal respiratory variability predicts severity of hypoxemia after generalized convulsive seizures.Epilepsia · 2023Article
- An exploratory study on the association between serotonin and sleep breathing disorders.Scientific reports · 2023Observational
- A narrative review of the mechanisms and consequences of intermittent hypoxia and the role of advanced analytic techniques in pediatric autonomic disorders.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Review
- Review
- Audiogenic epileptic DBA/2 mice strain as a model of genetic reflex seizures and SUDEP.Frontiers in neurology · 2023Review
- Serotonin transporter in the temporal lobe, hippocampus and amygdala in SUDEP.Brain pathology (Zurich, Switzerland) · 2022Article
- Functional MRI Correlates of Carbon Dioxide Chemosensing in Persons With Epilepsy.Frontiers in neurology · 2022Article
- Raphe and ventrolateral medulla proteomics in epilepsy and sudden unexpected death in epilepsy.Brain communications · 2022Article
Corrections and comments
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Authors and funding
23 authors at 9 institutions in 3 countries.
Funding
Abstract
objectiveIctal (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.
methodsPatients 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.
resultsFour 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).
conclusionsSeizures 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.
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