Jobe P C, Dailey J W, Wernicke J F
Department of Biomedical and Therapeutic Sciences, University of Illinois College of Medicine-Peoria, 61656, USA.
Crit Rev Neurobiol. 1999;13(4):317-56. doi: 10.1615/critrevneurobiol.v13.i4.10.
Noradrenergic and/or serotonergic deficits, as well as other abnormalities, may contribute to predisposition to some epilepsies and depressions. Evidence for this hypothesis stems from several sources. Epidemiological investigations are intriguing but incomplete. Pharmacological studies show that noradrenergic and/or serotonergic transmission are both anticonvulsant and antidepressant. Therapeutically pertinent investigations show that antidepressant drugs have anticonvulsant properties, whereas antiepileptic drugs are effective in the management of affective disorders. Additional investigations demonstrate that seizures, whether spontaneously occurring or therapeutically induced, protect against depression. Through studies of innate pathophysiology, noradrenergic and serotonergic deficits have been identified in individuals with depression and in animal models of epilepsy, as well as in some humans with epilepsy. Vagal nerve stimulation, a treatment already known to be effective in the epilepsies, is presently under investigation for effectiveness in affective disorder. New evidence suggests that vagal nerve stimulation exerts at least some of its therapeutic effects through its capacity to increase noradrenergic and serotonergic transmission. Finally, emerging evidence supports the concept that some genetic mammalian models of the human epilepsies exhibit analogous manifestations of depression.
去甲肾上腺素能和/或5-羟色胺能缺陷，以及其他异常情况，可能导致某些癫痫和抑郁症的易感性。这一假说的证据来源于多个方面。流行病学调查饶有趣味但并不完整。药理学研究表明，去甲肾上腺素能和/或5-羟色胺能传递既具有抗惊厥作用，也具有抗抑郁作用。治疗相关性研究表明，抗抑郁药物具有抗惊厥特性，而抗癫痫药物对情感障碍有效。进一步的研究表明，癫痫发作，无论是自发发生还是治疗诱发的，都能预防抑郁症。通过对先天性病理生理学的研究，在抑郁症患者、癫痫动物模型以及一些癫痫患者中都发现了去甲肾上腺素能和5-羟色胺能缺陷。迷走神经刺激，一种已知对癫痫有效的治疗方法，目前正在研究其对情感障碍的疗效。新证据表明，迷走神经刺激至少部分通过增加去甲肾上腺素能和5-羟色胺能传递来发挥其治疗作用。最后，新出现的证据支持这样一种观点，即人类癫痫的一些基因哺乳动物模型表现出类似的抑郁症状。
