Citalopram as a good candidate for treatment of depression in patients with epilepsy

Payandemehr, Borna; Ghasemi, Mehdi; Dehpour, Ahmad Reza

doi:10.1016/j.yebeh.2015.01.015

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…The rate of epileptogenesis in rats has been demonstrated to be enhanced by chronic SSRI treatment (28). However, clinical and animal experiments have demonstrated that SSRIs may decrease seizures, and these drugs are considered safe for use in epilepsy (3)(4)(5)25). In the present study, four weeks of paroxetine treatment alleviated seizures in pilocarpine-induced chronic epileptic rats.…”

Section: Discussionmentioning

confidence: 48%

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Novel insights into the effect of paroxetine administration in pilocarpine-induced chronic epileptic rats

Lin

et al. 2017

Molecular Medicine Reports

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The aim of the present study was to investigate the role of paroxetine intervention in epilepsy, and its association with the expression of serotonin transporter (SERT) and hippocampal apoptosis. Thirty adult male Sprague Dawley rats were divided into control vehicle (n=6) and epileptic (n=24) groups. Status epilepticus (SE) was induced via systemic injection of pilocarpine, and seizure activity was monitored via video electroencephalogram. The epileptic group was then randomly divided into two groups; Four weeks following SE induction, paroxetine (5 mg/kg/day; SE + paroxetine group) or normal saline (SE group) was intraperitoneally injected for 4 weeks. Brain tissue was collected to evaluate apoptosis via terminal deoxynucleotidyl transferase dUTP nick‑end labeling. SERT, B‑cell lymphoma‑2 (Bcl‑2) and brain derived neurotropic factor (BDNF) expression levels were evaluated by western blotting, and miR‑16 expression was evaluated by reverse transcription‑quantitative polymerase chain reaction. Paroxetine did not affect the mortality of the pilocarpine‑induced chronic epileptic rats. Spontaneous recurrent seizures (SSRs) were observed 7‑28 days following SE induction. The frequency and stage of the SSRs were reduced by paroxetine administration. Apoptotic cells were observed in the epileptic hippocampus. Following paroxetine intervention, the staining intensity and number of apoptotic cells were significantly decreased. Expression levels of BDNF and Bcl‑2 were lower in the SE group compared with the vehicle group. The former was not altered by paroxetine injection; however, the latter was increased. In the SE group, SERT expression was not altered in the raphe nucleus but was decreased in the hippocampus. Following paroxetine administration, SERT expression was decreased in the raphe nucleus and increased in the hippocampus. In the SE group, miR‑16 expression was decreased in the raphe nucleus and increased in the hippocampus. Following paroxetine administration, miR‑16 expression was not altered in the raphe nucleus but was reduced in the hippocampus. In conclusion, the seizures and hippocampal apoptosis observed in chronic epileptic rats were alleviated by paroxetine treatment. This effect may be associated with the reduced Bcl‑2 and BDNF expression and the modulation of SERT expression. The alterations in miR‑16 expression may provide a potential explanation for the modulation of apoptosis; however, further research is required to determine the complete underlying molecular mechanism.

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Section: Discussionmentioning

confidence: 48%

“…Selective serotonin reuptake inhibitors (SSRIs) were previously considered to increase the occurrence of seizures (1). Previously, clinical and experimental results indicated that SSRIs alleviate the susceptibility to seizures (2)(3)(4)(5). This effect is attributed to elevated levels of extracellular serotonin.…”

Section: Introductionmentioning

confidence: 99%

Novel insights into the effect of paroxetine administration in pilocarpine-induced chronic epileptic rats

Lin

et al. 2017

Molecular Medicine Reports

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“…Therefore, it is di cult for Chinese clinicians to fully convince the pharmaceutical advice based only on evidence medicine. For example: Citalopram is often used as a rst-line antidepressant for patients with epilepsy [35] in China. Pharmacists believe that for elderly patients, citalopram has a druginduced QT interval prolongation phenomenon with a high long-term risk.…”

Section: Discussionmentioning

confidence: 99%

Study on the feasibility of pharmacist intervention on management of antidepressant treatment in late life depression under MDT: a mixed methods study

Ju¹,

Qiu

et al. 2022

Preprint

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OBJECTIVE: To evaluate the effect of pharmacist intervention on antidepressant treatment in late life depression under multidisciplinary team (MDT). Method: Patients with late life depression were selected from psychological department of The Afliated Wuxi Mental Health Center of Jiangnan University from Jan. 2021 to Mar. 2022, and randomly divided into observation group and control group, with 90 cases in each group. After 3 months of follow-up, the control group was given antidepressants and routine intervention, while the observation group was treated with pharmacist intervention under MDT and the same antidepressants. The Hamilton Depression scale (HAMD), medication appropriateness index (MAI), potential inappropriate medication (PIM), adherence, quality of life and satisfaction, the incidence of adverse drug events (ADEs), number of medication regimen optimization and clinician adoption rate were observed in two groups before and after intervention. Results: At admission, there were no statistically difference in HAMD score, total MAI scores, PIM number, adherence and quality of life between two groups (P>0.05). After intervention, HAMD scores of both groups were significantly reduced, while MMAS-8, GQOLI-74 and GWB scores were elevated. Moreover, the differences of scores before and after interventions, both the reduction in HAMD score and the increase in MMAS-8, GQOLI-74 and GWB scores, were more significant in the observation group than in the control group. Interestingly, the total MAI score and PIM number were increased in the control group after intervention, but decreased in the observation group. With the prolongation of the treatment, the number of patients with mild to moderate depression and general to high medication adherence in two groups was increased gradually, while patients with major depression and low medication adherence were decreased gradually. Meanwhile, the observation group also showed more significant difference than the control group. Low adherence patients increased substantially at 90 days treatment in control group. There was no significant difference in the incidence of ADEs between two groups (P>0.05). The quality of life in the observation group was significantly higher than control group (P<0.05). Pharmacists put forward 164 optimization suggestions of drug regimen for the observation group, among which 109 suggestions were adopted and implemented by clinicians, with an implementation rate of 66.46%. Clinicians have a high adoption rate of pharmaceutical recommendations based on therapeutic drug monitoring (TDM), individualized genetic testing and medication methods. Conclusion: Pharmacist intervention can improve the management of antidepressant treatment in late life depression by using HAMD, MAI, PIM and MMAS-8 as main evaluation indicators under MDT.

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The comorbidity of epilepsy and depression: diagnosis and treatment

Tao

Wang

2016

Expert Review of Neurotherapeutics

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Depression can seriously affect the quality of life of epileptic patients and can even lead to suicide. Understanding the regularity, prevention and treatment of depression in patients with epilepsy (PWE) contributes to the improvement of their quality of life. Areas covered: In this paper, we retrospectively analyzed the relevant literature on the pathogenesis, related factors, clinical characteristics, diagnosis and treatment of depression in PWE. A literature search utilized the PubMed, Embase and Google Scholar databases. Expert commentary: PWE often have depression, which can be the result of seizures, antiepileptic drugs (AEDs) or social-demographic factors. It needs to be better understood, and the diagnosis should be more comprehensive for early treatment.

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Citalopram as a good candidate for treatment of depression in patients with epilepsy

Cited by 3 publications

References 28 publications

Novel insights into the effect of paroxetine administration in pilocarpine-induced chronic epileptic rats

Novel insights into the effect of paroxetine administration in pilocarpine-induced chronic epileptic rats

Study on the feasibility of pharmacist intervention on management of antidepressant treatment in late life depression under MDT: a mixed methods study

The comorbidity of epilepsy and depression: diagnosis and treatment

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