Torta Riccardo, Monaco Francesco
Department of Neurosciences, University of Turin, Italy.
Epilepsia. 2002;43 Suppl 2:8-13. doi: 10.1046/j.1528-1157.2002.043s2008.x.
To discuss the pharmacodynamic aspects of the administration of atypical antipsychotics (APs) and serotoninergic antidepressants (SSRIs) to patients with epilepsy.
This article represents an overview of all studies concerning the administration of APs and SSRIs to people with epilepsy. In particular, it deals with the relationship between neuroleptics (NLTs), APs, SSRIs, serotonin, and dopamine, with special focus on the possible epileptogenic role of psychoactive drugs.
NLTs may induce seizures by blocking D2, H1, and.1 receptors, or by sexual hormone activation or a pharmacologic kindling mechanism. The difference among APs in their ability to induce seizures is related mainly to the percentage of D2-receptor occupancy and possibly also to their action on neurosteroids. Seizures occur at SSRIs therapeutic doses, with a 0.1-4% incidence. Coversely, in animal studies fluoxetine was claimed to exert an anticonvulsant action.
The study of the pharmacodynamic aspects of the administration of APs and SSRIs to patients with epilepsy can help to evaluate the importance of some mechanisms of action of several psychoactive drugs in relation to their pro- or anticonvulsant activity.
探讨非典型抗精神病药物（APs）和5-羟色胺能抗抑郁药物（SSRIs）用于癫痫患者时的药效学方面。
本文对所有关于APs和SSRIs用于癫痫患者的研究进行了综述。特别探讨了抗精神病药物（NLTs）、APs、SSRIs、5-羟色胺和多巴胺之间的关系，重点关注精神活性药物可能的致癫痫作用。
NLTs可通过阻断D2、H1和α1受体，或通过性激素激活或药理点燃机制诱发癫痫发作。APs诱发癫痫发作的能力差异主要与D2受体占有率有关，也可能与其对神经甾体的作用有关。SSRIs在治疗剂量时可引发癫痫发作，发生率为0.1%-4%。相反，在动物研究中，氟西汀被认为具有抗惊厥作用。
研究APs和SSRIs用于癫痫患者时的药效学方面，有助于评估几种精神活性药物的某些作用机制与其促惊厥或抗惊厥活性相关的重要性。
