Depression in epilepsy

Mula, Marco

doi:10.1097/wco.0000000000000431

Cited by 57 publications

(34 citation statements)

References 83 publications

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“…To date, neurological/psychiatric comorbidities represent a severe problem in PWE. As reported, comorbidities sometimes can be more harmful than seizures themselves [32,34]. The "face validity" of this animal model was also supported by the potential antiepileptogenic effect of ETH both in childhood absence epilepsy and this strain [19,58].…”

Section: Resultssupporting

confidence: 62%

“…It was proven that not only PWE have a greater risk to develop a neuropsychiatric disorder, but also patients with primary neuropsychiatric disorders are at greater risk of developing epilepsy. Accordingly, in some conditions, comorbidities and seizures can be generated independently from the same underlying network disease [32,34,35]. To support this linkage, it has also been demonstrated as several drugs acting on the catecholaminergic system, such as antidepressant drugs, could be potential candidate for the prevention and/or treatment of several types of epilepsy and its related neuropsychiatric comorbidities [36][37][38]; similarly different ASDs such as valproate and carbamazepine are often used in the clinical management of mood disorders [32,39,40].…”

Section: Wag/rij Rats and Neuropsychiatric Comorbiditiesmentioning

confidence: 99%

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WAG/Rij rat model: a resource for the pharmacology of epileptogenesis and related neurological/psychiatric comorbidities

Leo

Nesci

et al. 2019

Neurosci Res Notes

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The discovery of potential antiseizure drugs (ASDs) requires the use of experimental models that can also provide a unique chance for identifying new effective molecules able to prevent and/or cure epilepsy. Most of the preclinical knowledge on epileptogenesis derives from studies performed on post-insult models that are characterized by a recognizable first insult, a silent period lasting until the onset of the first seizure and a chronic period characterized by spontaneous recurrent seizures (SRSs). At odds, genetic models, in which the first insult remains to be identified, have been poorly investigated. Among the genetic models, the WAG/Rij rat was validated as a suitable experimental model of absence epileptogenesis with neuropsychiatric symptomatology, in which, according to our previous hypothesis on SRSs onset, genes could be considered the first ‘insult’ underlying all plastic modifications supporting the occurrences of absence seizures in this strain. In fact, in several genetic models, the initial insult could be described as the mutation leading to epilepsy that, to date, remains to be defined in this strain. The silent period ends at the occurrence of the first SRS, which is approximately at 2-3 months of age in these rats and after that time the chronic phase initiates, in which, absence seizures increase over time underlying likely further epileptogenic processes. In this review, we describe both the features of this experimental model and the effects of several pharmacological treatments against epileptogenesis and its related comorbidities including depressive-like symptoms and cognitive decline.

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Section: Resultssupporting

confidence: 62%

Section: Wag/rij Rats and Neuropsychiatric Comorbiditiesmentioning

confidence: 99%

WAG/Rij rat model: a resource for the pharmacology of epileptogenesis and related neurological/psychiatric comorbidities

Leo

Nesci

et al. 2019

Neurosci Res Notes

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“…Furthermore, in our study we asked the patients whether they felt depressed or down/blue and did not use a more objective evaluation of depressive symptoms. 24 It is likely that many of the patients reporting feeling depressed in our survey do not have clinical depression, and this probably explains the high occurrence (nearly 60%) in our sample.…”

Section: Psychosocial Problemsmentioning

confidence: 78%

Challenges in epilepsy—The perspective of Norwegian epilepsy patients

et al. 2019

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Objectives For most people with epilepsy (PWE), problems that are not directly related to seizures may constitute major challenges in everyday life. The purpose of this study was to determine the extent of these challenges and any risk factors for their occurrence among PWE in Norway, based on the patients’ own perspective. Materials and Methods We used a web‐based survey to ask PWE visiting the homepage of the Norwegian Epilepsy Association about different everyday challenges. A link to the survey was accessible via the members’ homepage for a 4‐month period during 2017. Results One thousand one hundred eighty‐two PWE responded to the questionnaire. Although more than 40% of the cohort reported that they had been seizure free for at least 1 year, the majority reported that tiredness (71%), memory problems (70%), concentration problems (68%), headache or vertigo (51%), and feeling depressed (59%) continued to represent challenges. In addition, fear of being alone, sexual problems or difficulties in social settings were reported by about one‐third of the patients. Reporting having these challenges was significantly associated with female gender, polytherapy, experiencing seizures during the previous 12 months and feeling blue or depressed. Conclusions The results of this study, reflecting a self‐selected Norwegian population, provide insights into the challenges not directly associated with seizures that impact on the quality of life of PWE. The impacts of such challenges may be underestimated as components of the entire burden of epilepsy.

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“…In a recent review, a number of studies suggested that depression is associated with an increased risk of epilepsy (55). The effectiveness of conventional antidepressant therapies is frequently examined in animals.…”

Section: Resultsmentioning

confidence: 99%

The Current Status of the Ketogenic Diet in Psychiatry

Bostock

Kirkby

Taylor³

2017

Front. Psychiatry

107

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BackgroundThe ketogenic diet (KD) has been used in treatment-resistant epilepsy since the 1920s. It has been researched in a variety of neurological conditions in both animal models and human trials. The aim of this review is to clarify the potential role of KD in psychiatry.MethodsNarrative review of electronic databases PubMED, PsychINFO, and Scopus.ResultsThe search yielded 15 studies that related the use of KD in mental disorders including anxiety, depression, bipolar disorder, schizophrenia, autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD). These studies comprised nine animal models, four case studies, and two open-label studies in humans. In anxiety, exogenous ketone supplementation reduced anxiety-related behaviors in a rat model. In depression, KD significantly reduced depression-like behaviors in rat and mice models in two controlled studies. In bipolar disorder, one case study reported a reduction in symptomatology, while a second case study reported no improvement. In schizophrenia, an open-label study in female patients (n = 10) reported reduced symptoms after 2 weeks of KD, a single case study reported no improvement. In a brief report, 3 weeks of KD in a mouse model normalized pathological behaviors. In ASD, an open-label study in children (n = 30) reported no significant improvement; one case study reported a pronounced and sustained response to KD. In ASD, in four controlled animal studies, KD significantly reduced ASD-related behaviors in mice and rats. In ADHD, in one controlled trial of KD in dogs with comorbid epilepsy, both conditions significantly improved.ConclusionDespite its long history in neurology, the role of KD in mental disorders is unclear. Half of the published studies are based on animal models of mental disorders with limited generalizability to the analog conditions in humans. The review lists some major limitations including the lack of measuring ketone levels in four studies and the issue of compliance to the rigid diet in humans. Currently, there is insufficient evidence for the use of KD in mental disorders, and it is not a recommended treatment option. Future research should include long-term, prospective, randomized, placebo-controlled crossover dietary trials to examine the effect of KD in various mental disorders.

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Depression in epilepsy

Cited by 57 publications

References 83 publications

WAG/Rij rat model: a resource for the pharmacology of epileptogenesis and related neurological/psychiatric comorbidities

WAG/Rij rat model: a resource for the pharmacology of epileptogenesis and related neurological/psychiatric comorbidities

Challenges in epilepsy—The perspective of Norwegian epilepsy patients

The Current Status of the Ketogenic Diet in Psychiatry

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