Citraro Rita, Leo Antonio, De Fazio Pasquale, De Sarro Giovambattista, Russo Emilio
Pharmacology Unit, Science of Health Department School of Medicine and Surgery, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy.
Psichiatry Unit, Science of Health Department School of Medicine and Surgery, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy.
Br J Pharmacol. 2015 Jun;172(12):3177-88. doi: 10.1111/bph.13121. Epub 2015 Apr 10.
Two of the most relevant unmet needs in epilepsy are represented by the development of disease-modifying drugs able to affect epileptogenesis and/or the study of related neuropsychiatric comorbidities. No systematic study has investigated the effects of chronic treatment with antipsychotics or antidepressants on epileptogenesis. However, such drugs are known to influence seizure threshold.
We evaluated the effects of an early long-term treatment (ELTT; 17 weeks), started before seizure onset (P45), with fluoxetine (selective 5-HT-reuptake inhibitor), duloxetine (dual-acting 5-HT-noradrenaline reuptake inhibitor), haloperidol (typical antipsychotic drug), risperidone and quetiapine (atypical antipsychotic drugs) on the development of absence seizures and comorbid depressive-like behaviour in the WAG/Rij rat model. Furthermore, we studied the effects of these drugs on established absence seizures in adult (6-month-old) rats after a chronic 7 weeks treatment.
ELTT with all antipsychotics did not affect the development of seizures, whereas, both ELTT haloperidol (1 mg · kg(-1) day(-1)) and risperidone (0.5 mg · kg(-1) day(-1)) increased immobility time in the forced swimming test and increased absence seizures only in adult rats (7 weeks treatment). In contrast, both fluoxetine (30 mg · kg(-1) day(-1)) and duloxetine (10-30 mg · kg(-1) day(-1)) exhibited clear antiepileptogenic effects. Duloxetine decreased and fluoxetine increased absence seizures in adult rats. Duloxetine did not affect immobility time; fluoxetine 30 mg · kg(-1) day(-1) reduced immobility time while at 10 mg · kg(-1) day(-1) an increase was observed.
In this animal model, antipsychotics had no antiepileptogenic effects and might worsen depressive-like comorbidity, while antidepressants have potential antiepileptogenic effects even though they have limited effects on comorbid depressive-like behaviour.
癫痫领域两个最相关的未满足需求表现为能够影响癫痫发生的疾病修饰药物的研发和/或相关神经精神共病的研究。尚无系统性研究调查抗精神病药物或抗抑郁药物的长期治疗对癫痫发生的影响。然而,已知这类药物会影响癫痫发作阈值。
我们评估了在癫痫发作开始前(P45)开始的早期长期治疗(ELTT;17周),使用氟西汀(选择性5-羟色胺再摄取抑制剂)、度洛西汀(双效5-羟色胺-去甲肾上腺素再摄取抑制剂)、氟哌啶醇(典型抗精神病药物)、利培酮和喹硫平(非典型抗精神病药物)对WAG/Rij大鼠模型失神发作的发展及共病抑郁样行为的影响。此外,我们研究了这些药物在成年(6月龄)大鼠经7周慢性治疗后对已确立的失神发作的影响。
所有抗精神病药物的ELTT均未影响癫痫发作的发展,而ELTT氟哌啶醇(1毫克·千克⁻¹·天⁻¹)和利培酮(0.5毫克·千克⁻¹·天⁻¹)在强迫游泳试验中增加了不动时间,且仅在成年大鼠(7周治疗)中增加了失神发作。相比之下,氟西汀(30毫克·千克⁻¹·天⁻¹)和度洛西汀(10 - 30毫克·千克⁻¹·天⁻¹)均表现出明显的抗癫痫发生作用。度洛西汀减少了成年大鼠的失神发作,氟西汀增加了失神发作。度洛西汀未影响不动时间;氟西汀30毫克·千克⁻¹·天⁻¹减少了不动时间,而在10毫克·千克⁻¹·天⁻¹时观察到增加。
在这个动物模型中,抗精神病药物没有抗癫痫发生作用,可能会加重抑郁样共病,而抗抑郁药物具有潜在的抗癫痫发生作用,尽管它们对共病抑郁样行为的影响有限。