Document Detail

Antidepressant therapy in epilepsy: can treating the comorbidities affect the underlying disorder?
MedLine Citation:
PMID:  23146067     Owner:  NLM     Status:  MEDLINE    
There is a high incidence of psychiatric comorbidity in people with epilepsy (PWE), particularly depression. The manifold adverse consequences of comorbid depression have been more clearly mapped in recent years. Accordingly, considerable efforts have been made to improve detection and diagnosis, with the result that many PWE are treated with antidepressant drugs, medications with the potential to influence both epilepsy and depression. Exposure to older generations of antidepressants (notably tricyclic antidepressants and bupropion) can increase seizure frequency. However, a growing body of evidence suggests that newer ('second generation') antidepressants, such as selective serotonin reuptake inhibitors or serotonin-noradrenaline reuptake inhibitors, have markedly less effect on excitability and may lead to improvements in epilepsy severity. Although a great deal is known about how antidepressants affect excitability on short time scales in experimental models, little is known about the effects of chronic antidepressant exposure on the underlying processes subsumed under the term 'epileptogenesis': the progressive neurobiological processes by which the non-epileptic brain changes so that it generates spontaneous, recurrent seizures. This paper reviews the literature concerning the influences of antidepressants in PWE and in animal models. The second section describes neurobiological mechanisms implicated in both antidepressant actions and in epileptogenesis, highlighting potential substrates that may mediate any effects of antidepressants on the development and progression of epilepsy. Although much indirect evidence suggests the overall clinical effects of antidepressants on epilepsy itself are beneficial, there are reasons for caution and the need for further research, discussed in the concluding section.
L Cardamone; M R Salzberg; T J O'Brien; N C Jones
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  British journal of pharmacology     Volume:  168     ISSN:  1476-5381     ISO Abbreviation:  Br. J. Pharmacol.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-15     Completed Date:  2013-11-25     Revised Date:  2014-04-01    
Medline Journal Info:
Nlm Unique ID:  7502536     Medline TA:  Br J Pharmacol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1531-54     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. British Journal of Pharmacology © 2012 The British Pharmacological Society.
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MeSH Terms
Antidepressive Agents / therapeutic use*
Antidepressive Agents, Tricyclic / therapeutic use
Anxiety / drug therapy*,  epidemiology,  physiopathology
Anxiety Disorders / drug therapy,  epidemiology,  physiopathology
Brain / drug effects,  physiopathology
Depression / drug therapy*,  epidemiology,  physiopathology
Depressive Disorder / drug therapy,  epidemiology,  physiopathology
Epilepsy / drug therapy,  epidemiology,  physiopathology*
Seizures / drug therapy,  epidemiology,  physiopathology
Serotonin Uptake Inhibitors / therapeutic use
Reg. No./Substance:
0/Antidepressive Agents; 0/Antidepressive Agents, Tricyclic; 0/Serotonin Uptake Inhibitors

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