Fluoxetine, a Selective Serotonin‐Uptake Inhibitor, Enhances the Anticonvulsant Effects of Phenytoin, Carbamazepine, and Ameltolide (LY 201116)

Jd, Leander

doi:10.1111/j.1528-1157.1992.tb01712.x

Cited by 92 publications

(38 citation statements)

References 14 publications

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“…Among the SSRIs, fluoxetine has been claimed to exert an anticonvulsant action in animal studies (198)(199)(200)(201). Other favorable data are coming from a few controlled clinical studies, particularly with fluoxetine, in which a possible anticonvulsant action of this drug as adjunctive therapy of partial complex seizures was suggested (202,203).…”

Section: )mentioning

confidence: 99%

Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

1999

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Summary: This chapter deals with some aspects of psychiatric disturbances in people with epilepsy. Because depression and its treatment are extensively described later in this issue, they are not discussed here. The same pertains to forced normalization. Key Words: Epilepsy-Anxiety-PsychosisDepress ion-Qua1 i ty of 1 i fe-Ps e u do s ei zure s-A n t idepressants-Antipsychotics-Antiepileptic drugs.Although most people with epilepsy lead a normal emotional and cognitive life, neurobehavioral problems can be found in a large number of patients. Higher rates of psychopathology are observed in people with epilepsy relative to the general population (1,2), to other neurologic control groups (3), and to people with chronic nonneurologic disorders (1,4). In particular, increased psychopathology is more common in temporal lobe epilepsy (TLE) than in generalized epilepsy (5). Nevertheless, many issues remain highly controversial, owing in part to several methodologic problems, such as the nosographic approach, the sample examined, the type of control groups, the comparison among nonhomogeneous forms of epilepsy, and the different antiepileptic drugs (AEDs).Psychiatric disturbances can be related either to involvement of brain structures (biologic pathogenesis) or to the chronic characteristics of epilepsy (psychosocial pathogenesis). These psychiatric symptoms may develop in relationship to the seizures (in prodromal, ictal, or postictal periods) but more commonly are present in a chronic interictal condition.The wide range of clinical diversity is related to the anatomic foci, to patterns of spread, and to biologic or psychological differences among patients. Interictal behavioral changes in epilepsy remain controversial and difficult to define, mainly because pathogenesis may be attributable to several factors, such as epilepsy itself, possible brain lesions, the AEDs prescribed, and psychosocial problems (6). On the other hand, the existence of cognitive changes in epilepsy is well established, and Addrress correspondence and reprint requests to Dr. Riccardo Tom at Dipartimento di Neuroscienze, via Cherasco 11, 10126 Torino, Italy.sometimes the presence of cognitive disorders can facilitate the appearance of psychiatric disturbances (7).One of the most widely discussed problems is the incidence of psychiatric pathology in epilepsy, with a wide range of values in the literature related to the type of study. Epilepsy is characterized by a broad spectrum of severity. Ideally, patients for study trials should be selected consecutively from a general epilepsy population, but most epidemiologic studies are carried out in centers for epilepsy and include many refractory subjects who demonstrate a range of pathologic disturbances more severe than those observed in the general population of patients with epilepsy. In community studies, the prevalence of associated psychiatric disorders is low, whereas in specialty referral centers, particularly those serving indigent populations, the prevalence can rise to 25-50%: Among patient...

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Section: )mentioning

confidence: 99%

Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

1999

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“…Among the new AD SSRIs, fluoxetine has been employed as an anticonvulsant both in experimental animals (26,27) and in humans (28,29). For drug interactions with AEDs, fluoxetine has shown either to increase CBZ plasma levels (30,3 1) or not to modify them (1 8,32,33).…”

Section: Ads Vs Aedsmentioning

confidence: 99%

Interactions Between Anticonvulsant and Psychoactive Drugs

Monaco

Cicolin

1999

Epilepsia

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Summary: This review considers the relevance of pharmacokinetic interactions between antiepileptic drugs (AEDs) and psychoactive drugs in the treatment of mood disorders in patients with epilepsy. The determination of plasma levels of some of these drugs (mainly the AEDs) has enabled clinicians to evaluate the kinetic modifications during the course of such combined therapies and to adjusting the dosages in cases of subtherapeutic or toxic levels. In general, phenobarbital, phenytoin, and carbamazepine stimulate the catabolic degradation of tricyclic antidepressants (TCAs), and TCAs have an inhibitory effect on the elimination of AEDs. The newer antidepressants that selectively inhibit the reuptake of serotonin (SSRIs), although in different fashions for the different substances (fluoxetine, fluvoxamine, paroxetine) may cause an increase of plasma AED levels through inhibition of the isoenzyme P450 2D6. Similarly, antipsychotics (APs) are more rapidly metabolized when AEDs are co-administered, whereas AED metabolism is scarcely influenced by AP. Finally, plasma levels of tranquilizers are lowered by AED co-therapy. As the concomitant administration of AED and psychoactive drugs becomes increasingly used for treatment of mood disorders in patients with or without epilepsy, therapeutic drug monitoring may be useful in designing correct and rational therapy.

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“…Therefore, it is not surprising that fluoxetine was found to enhance the anticonvulsant potency of traditionally used antiepileptic drugs (19,20), and moreover, the drug exerted franc anticonvulsant action in animal as well as human studies (21)(22)(23)(24)(25).…”

Section: Introductionmentioning

confidence: 99%

Differential effects of fluoxetine enantiomers in mammalian neural and cardiac tissues

et al. 2003

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Abstract. Racemic fluoxetine is a widely used SSRI antidepressant compound having also anticonvulsant effect. In addition, it was shown that it blocked several types of voltage gated ion channels including neural and cardiac calcium channels. In the present study the effects of enantiomers of fluoxetine (R(-)-fluoxetine and S(+)-fluoxetine) were compared on neuronal and cardiac voltage-gated Ca 2+ channels using the whole cell configuration of patch clamp techniques, and the anticonvulsant action of these enantiomers was also evaluated in a mouse epilepsy model. In isolated pyramidal neurons of the dorsal cochlear nucleus of the rat the effect of fluoxetine (S(+), R(-) and racemic) was studied on the Ca 2+ channels by measuring peak Ba 2+ current during ramp depolarizations. All forms of fluoxetine reduced the Ba

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Fluoxetine, a Selective Serotonin‐Uptake Inhibitor, Enhances the Anticonvulsant Effects of Phenytoin, Carbamazepine, and Ameltolide (LY 201116)

Cited by 92 publications

References 14 publications

Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

Interactions Between Anticonvulsant and Psychoactive Drugs

Differential effects of fluoxetine enantiomers in mammalian neural and cardiac tissues

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