Citraro Rita, Leo Antonio, Aiello Rossana, Pugliese Michela, Russo Emilio, De Sarro Giovambattista
Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Viale Europa - Germaneto, 88100, Catanzaro, Italy.
Neurotherapeutics. 2015 Jan;12(1):250-62. doi: 10.1007/s13311-014-0318-6.
Antipsychotic drugs (APs) are of great benefit in several psychiatric disorders, but they can be associated with various adverse effects, including seizures. To investigate the effects of chronic antipsychotic treatment on seizure susceptibility in genetically epilepsy-prone rats, some APs were administered for 7 weeks, and seizure susceptibility (audiogenic seizures) was evaluated once a week during treatment and for 5 weeks after drug withdrawal. Furthermore, acute and subchronic (5-day treatment) effects were also measured. Rats received haloperidol (0.2-1.0 mg/kg), clozapine (1-5 mg/kg), risperidone (0.03-0.50 mg/kg), quetiapine (2-10 mg/kg), aripriprazole (0.2-1.0 mg/kg), and olanzapine (0.13-0.66 mg/kg), and tested according to treatment duration. Acute administration of APs had no effect on seizures, whereas, after regular treatment, aripiprazole reduced seizure severity; haloperidol had no effects and all other APs increased seizure severity. In chronically treated rats, clozapine showed the most marked proconvulsant effects, followed by risperidone and olanzapine. Quetiapine and haloperidol had only modest effects, and aripiprazole was anticonvulsant. Finally, the proconvulsant effects lasted at least 2-3 weeks after treatment suspension; for aripiprazole, a proconvulsant rebound effect was observed. Taken together, these results indicate and confirm that APs might have the potential to increase the severity of audiogenic seizures but that aripiprazole may exert anticonvulsant effects. The use of APs in patients, particularly in patients with epilepsy, should be monitored for seizure occurrence, including during the time after cessation of therapy. Further studies will determine whether aripiprazole really has a potential as an anticonvulsant drug and might also be clinically relevant for epileptic patients with psychiatric comorbidities.
抗精神病药物(APs)对多种精神疾病有很大益处,但它们可能会引发各种不良反应,包括癫痫发作。为了研究慢性抗精神病药物治疗对遗传性癫痫易感性大鼠癫痫易感性的影响,给予一些抗精神病药物7周,并在治疗期间每周评估一次癫痫易感性(听源性癫痫发作),停药后评估5周。此外,还测量了急性和亚慢性(5天治疗)效应。大鼠接受氟哌啶醇(0.2 - 1.0毫克/千克)、氯氮平(1 - 5毫克/千克)、利培酮(0.03 - 0.50毫克/千克)、喹硫平(2 - 10毫克/千克)、阿立哌唑(0.2 - 1.0毫克/千克)和奥氮平(0.13 - 0.66毫克/千克),并根据治疗持续时间进行测试。抗精神病药物的急性给药对癫痫发作没有影响,而在常规治疗后,阿立哌唑降低了癫痫发作的严重程度;氟哌啶醇没有影响,其他所有抗精神病药物都增加了癫痫发作的严重程度。在长期治疗的大鼠中,氯氮平表现出最明显的促惊厥作用,其次是利培酮和奥氮平。喹硫平和氟哌啶醇只有适度的影响,而阿立哌唑具有抗惊厥作用。最后,促惊厥作用在停药后至少持续2 - 3周;对于阿立哌唑,观察到了促惊厥的反弹效应。综上所述,这些结果表明并证实抗精神病药物可能有增加听源性癫痫发作严重程度的潜力,但阿立哌唑可能具有抗惊厥作用。在患者中使用抗精神病药物,尤其是癫痫患者,应监测癫痫发作的发生情况,包括在治疗停止后的一段时间内。进一步的研究将确定阿立哌唑是否真的有作为抗惊厥药物的潜力,以及对患有精神疾病合并症的癫痫患者是否也具有临床相关性。