Singh Tanveer, Goel Rajesh Kumar
Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India.
Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India.
Epilepsy Behav. 2017 Jan;66:93-99. doi: 10.1016/j.yebeh.2016.10.007. Epub 2016 Dec 27.
Depression is one of the major psychiatric comorbidities having a major impact on the quality of life in people with epilepsy (PWE). Selective serotonin reuptake inhibitors (SSRIs) are considered as safest therapy for the treatment of depression in PWE. Although administration of SSRIs increases the synaptic serotonin levels, it decreases the overall serotonin synthesis in the brain. Long-term therapy with SSRIs has been reported to decrease serotonin synthesis, which may be the possible reason for lessening of their antidepressant effect over time as well as elevated seizure outcomes observed in PWE. Thus the present scenario warrants streamlined studies to explore the safety and efficacy of SSRIs as well as approaches beyond SSRIs for treatment of depression in epilepsy. In this review, we outline the approaches which may restore serotonin levels rather than a pseudo enhancement of serotonin with SSRIs. The potential of various anti-inflammatory approaches such as selective cyclooxygenase-2 inhibitors, inflammatory cytokine inhibitors, and indoleamine 2,3-dioxygenase inhibitors pertaining to their serotonin restoring effects is discussed as possible therapy for treatment of depression in epilepsy.
抑郁症是对癫痫患者（PWE）生活质量有重大影响的主要精神共病之一。选择性5-羟色胺再摄取抑制剂（SSRI）被认为是治疗PWE抑郁症最安全的疗法。虽然服用SSRI会增加突触5-羟色胺水平，但会降低大脑中整体5-羟色胺的合成。据报道，长期使用SSRI治疗会降低5-羟色胺的合成，这可能是随着时间推移其抗抑郁作用减弱以及PWE癫痫发作结果增加的可能原因。因此，当前的情况需要进行简化研究，以探索SSRI的安全性和有效性以及治疗癫痫抑郁症的SSRI以外的方法。在这篇综述中，我们概述了可能恢复5-羟色胺水平的方法，而不是用SSRI假增强5-羟色胺。讨论了各种抗炎方法的潜力，如选择性环氧化酶-2抑制剂、炎性细胞因子抑制剂和吲哚胺2,3-双加氧酶抑制剂，因其5-羟色胺恢复作用作为治疗癫痫抑郁症的可能疗法。
