In patients with focal epilepsies, SSRI therapy prolonged EEG seizure duration but not postictal EEG depression after seizures.
BOSTON—Treatment with selective serotonin reuptake inhibitors (SSRIs) is associated with prolonged electroencephalographic (EEG) seizure duration in patients with focal epilepsies, according to research presented at the 63rd Annual Meeting of the American Epilepsy Society.
Eugen Trinka, MD, MSc, of the Department of Neurology at Medical University Innsbruck, Austria, and colleagues performed a case control study of 162 patients with focal epilepsies admitted for presurgical evaluation in the Video-EEG Monitoring Unit in Innsbruck between January 2006 and March 2008. EEG seizure duration was compared with duration of convulsions and postictal EEG depression after secondary generalized tonic-clonic seizures.
Cases were patients with focal complex seizures and secondary generalized tonic-clonic seizures who were treated continuously with SSRIs during monitoring. Controls were selected from patients with the same seizure type matched to a case according to sex, age, epilepsy etiology (symptomatic or cryptogenic), and type of recording (surface or intracranial EEG). Seizures were matched in order of appearance during monitoring sessions.
Dr. Trinka’s group identified 19 complex partial seizures and 16 secondary generalized tonic-clonic seizures among 11 patients treated with SSRIs and matched them with the same seizure type among 13 controls. A total of 35 case-control pairs were assessed in the final analysis.
“EEG seizure duration in patients treated with SSRIs (median 132 seconds) lasted significantly longer than for controls (median 85 seconds),” Dr. Trinka and coauthors stated. “EEG seizure duration of the secondary generalized tonic-clonic cases (median 126 seconds) was longer than EEG seizure duration of the controls (median 113.5 seconds).” Also, focal complex seizure cases had longer EEG seizure duration than controls (median 133 seconds vs median 62 seconds).
No statistical difference was shown between the convulsive phase of secondary generalized tonic-clonic cases and the matched controls (median 66 seconds vs median 68 seconds), or for the duration of postictal EEG depression after secondary generalized tonic-clonic seizures between cases and controls (median 214.5 seconds vs median 219.5 seconds, respectively).
“Our results suggest that SSRI treatment is associated with prolonged electroencephalographic seizure duration in patients with focal epilepsies,” Dr. Trinka’s group concluded.
—Laura Sassano