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Antidepressants may reduce epilepsy sudden death


Selective Serotonin Reuptake Inhibitors (SSRIs) may reduce the risk of Sudden Unexpected Death in Epilepsy (SUDEP), according to research published in the journal Epilepsy & Behavior.

The study, conducted by Dr Faingold and colleagues from Southern Illinois University School of Medicine, evaluated whether administration of an agent that enhances the availability of serotonin (5-hydroxytryptamine, 5-HT), the SSRI fluoxetine, would be effective in preventing sudden death in DBA/1 mice.

The study found that semi-chronic (five-day) treatment with fluoxetine is a useful approach to prevent sudden death in the DBA/1 mice SUDEP model in doses that did not suppress the seizures.

This effect was temporary, and susceptibility to sudden death returned one-to-three days after fluoxetine treatment.

Future studies with other SSRIs and other selective 5-HT agonists, as well as longer-term treatment paradigms to evaluate these issues more thoroughly, will need to be performed.

“Dr Faingold and colleagues have made a very important observation which, with further study, holds the promise for the development of treatments to lessen the risk of the devastating problem of SUDEP,” said Steven Schachter, Professor of Neurology at Harvard Medical School.

Dr George Richerson, Chairman of Neurology at the University of Iowa, added, “This paper is a major advance, because it shows in a well-validated animal model that semi-chronic treatment with a safe and widely used drug can prevent both respiratory arrest and sudden death.

“Although this does not directly prove that this approach would be effective in humans, it provides a strong rationale for clinical trials to prevent the most common cause of death in epilepsy patients, which has previously been unpreventable.”

Epilepsy & Behavior 

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