Selective serotonin reuptake inhibitors prolong seizures - Preliminary results from an observational study

Objective: Selective serotonin reuptake inhibitors (SSRIs) are often used in the treatment of depressive disorders in patients with epilepsy. Pro- and anti-convulsive effects of SSRIs are discussed controversially. The aim of this study was to investigate a possible impact of SSRIs-treatment on duration of EEG and clinical features in epilepsy patients. Methods: We studied video-EEG data from 162 patients with focal epilepsies between January 2006 and March 2008 using a case-control study design. Eleven patients with 19 complex focal seizures (CFSs) and 16 secondary generalized tonic-clonic seizures (sGTCSs) treated with SSRIs (SSRIs+) were matched to 13 patients without SSRIs-treatment (SSRIs-). We compared duration of ictal EEG in CFSs and sGTCSs, duration of convulsions in sGTCSs and duration of postictal EEG suppression after sGTCSs in SSRIs+ and SSRIs- patients. Results: Ictal EEG duration of both, CFSs and sGTCSs, was significantly longer in SSRIs+ patients than in SSRIs- patients (p = 0.004 and p = 0.015, respectively). No significant difference was found between convulsive phase duration of sGTCSs as well as duration of postictal EEG suppression after sGTCSs in both groups. Conclusion: Seizures last significantly longer in patients with epilepsy and SSRIs as co-medication. A causative role of SSRIs in ictal activity has to be explored in prospective studies. (C) 2014 Elsevier B.V. All rights reserved.