ISSN: 2167-1044
Journal of Depression and Anxiety
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
 
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business
 

Iatrogenic depression with Antiepileptic Drug Therapy in Patients with Partial Seizures

Sahar Mohamed Kamal Shams El-Dine*
Pharmacology laboratory- Faculty of Medicine – Ain Shams University- Cairo- Egypt
Corresponding Author : Sahar Mohamed Kamal Shams El-Dine
Faculty of Medicine, Pharmacology laboratory
Ain Shams University, Cairo, Egypt
Email: saharkamal2003@hotmail.com
Received April 17, 2015; Accepted July 22, 2015; Published July 25, 2015
Citation: El-Dine SMKS (2015) Iatrogenic depression with Antiepileptic Drug Therapy in Patients with Partial Seizures. J Depress Anxiety 4:188. doi:10.4172/2167-1044.1000188
Copyright: © 2015 El-Dine SMKS. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Related article at Pubmed, Scholar Google

Visit for more related articles at Journal of Depression and Anxiety

Short Communication
Seizures are defined to be transient paroxysms of uncontrolled neuronal discharge leading to a clinical behavioral disorder.
Partial seizures, according to Browne and Holmes [1] are classified to simple (focal) and complex (temporal lobe or psychomotor) types. The focal type is characterized by motor, sensory and psychic symptoms. As it is focal, the symptoms depend on the location of the abnormal electrical discharge, however, the consciousness is not impaired. On the other hand, the complex type may begin without any warning or as focal type with impaired consciousness. It is also characterized by automatism and is followed by a period of confusion.
Gamma amino butyric acid (GABA) and glutamate play an important role in its pathogenesis. Impairement of the inhibitory effect of GABA occurs in different forms including: defective GABAA receptor inhibition- Defectibe GABAB receptor inhibition or defective intracellular Na+-Ca++ exchange. Additionally, glutamate can increase the excitation via increased activation of NMDA receptors- increased synchrony between neurons via recurrent excitatory collaterals.
Generally, the antiepileptic drugs act either via GABA-mimetic action, or an inhibition of glutamate neurotransmission or an inhibition of T-type Ca++ channels or an inhibition of Na+ channels
In partial seizures, we have first and second lines drugs acting via one or more of the above mechanisms of actions. They are:
First Line Drugs: Levetiracetam, Carbamazepine, Oxcarbazepine, Lamotrigine
Second Line Drugs: Lacosamide, Pregabalin
On the other hand, depression in children and adolescents with partial epilepsy is common. It worsen the quality of life in these epileptic patients even if they were well treated with the recommended line of therapy of these type of seizures. Several studies determined the neurobiological, social, and drug-induced (iatrogenic) factors that enhance the development of this depressive disorder and hence affect the response to the anti-epileptic treatment. A case report of a patient with partial epilepsy, secondary to a neonatal stroke, suffered from a depressive disorder when he received levetiracetam (LEV) as a treatment of the partial seizures [2-3]. The authors reported that there is a possible incidence of iatrogenic effect of LEV in the occurrence of depressed mood in this epileptic case. However, dose adjustment of LEV showed a marked reduction of the high incidence of depression comorbidity in pediatric epileptic patients.
So the dose adjustment and the frequent therapeutic drug monitoring of any selected drug from the two lines of therapy in partial seizure with depressed mood are mandatory to achieve both the efficacy and safety of these anti-epileptic drugs and to reduce the incidence of depression or the augmentation of the clinical severity of the disease in such patients.
If the patient is a woman in child bearing period , the physician selects either Oxcarbazepine or Levetiracetam. In elderly patient, Levetiracetam is used. Again dose adjustment and close therapeutic drug monitoring are essential to be done in these special populations. The clinician should take care from carbamazepine, being an enzyme inducer, it would be used very cautiously with the co-administration of anti-depressant drugs. Dose adjustment is mandatory in such cases to avoid serious adverse effects.
Another case report in 2013 reported that levetiracetam (LEV) can induce serious psychiatric adverse effects including de novo psychosis, affective disorder, and aggression. LEV-induced suicidal behavior has been reported infrequently with a past history of affective disorders [4-7]. The authors report an apparent dose/concentration-dependent LEV-induced de novo major depression with near fatal suicide attempt in a patient without prior history of affective disorder. So these adverse effects necessitate a perfect psychiatric evaluation with a good estimation of benefit/risk effect of LEV on already existing affective disorders, impulsive–aggressive behaviors in patients with partial seizures. Assessment of risk factors for suicidal behaviors is indicated in patients with epilepsy and treated with LEV.
The main issue in treatment of partial seizures with depressed mood is to provide physician and patient counselling about this co-morbid diseases and the precautions in administration of the recommended anti-epileptic drugs regarding: proper diagnosis- therapeutic drug monitoring- preferable monotherapy of partial seizures using the appropriate drug to the clinical condition of the depressed patient- Small dose of co-administered SSRIs and long duration of administration together with the selected antiepileptic drugs-Gradual withdrawal and take care of special population esp. pregnant females.
Studies are now planned to explore in which degree these lines of drug therapy in this case of co-morbidity could enhance the potential therapeutic benefit in the drug therapy of depressed patients with partial seizures and how to avoid the occurance of serious adverse effects by using the possible small therapeutic doses. The results will be very interesting since a future perspective in treatment of depression with partial seizures with minimum adverse effects or drug interactions could become reality.
References







 
Select your language of interest to view the total content in your interested language
 
Share This Article
   
 
   
 
Relevant Topics
Disc
Disc ADHD
Disc Abnormal Behavior
Disc Abnormal Psychology
Disc Addiction Psychiatry
Disc Adolescent Psychiatry
Disc Adolescent behaviour
Disc Antisocial Personality Disorder
Disc Anxiety
Disc Anxiety Disorders
Disc Applied Psychology
Disc Behavioural Science
Disc Biological Psychiatry
Disc Biopsychology
Disc Bipolar Affective
Disc Bipolar Affective Disorders
Disc Bipolar Psychosis
Disc Brain Aneurysm
Disc Brain Mapping
Disc Brain Scan
Disc Brain Stem Cell Therapy
Disc Brain Stroke
Disc Brain Structure and Function
Disc Brain Trauma/ Injury
Disc Brain Tumor
Disc CNS and Neurological Disorders
Disc Cerebral Palsy
Disc Child Psychiatry
Disc Child and Adolescent Psychiatry
Disc Child autism
Disc Child behavior
Disc Child development
Disc Childhood Anxiety
Disc Childhood Disorders
Disc Children thinking
Disc Chronic Criminals
Disc Clinical Psychiatry
Disc Cognitive Disorders
Disc Cognitive Mental Illness
Disc Cognitive Psychology Research
Disc Cognitive Science
Disc Cognitive psychology
Disc Coma
Disc Community Psychiatry
Disc Comparative Psychology
Disc Convulsion
Disc Correctional Psychologist
Disc Counseling Psychology
Disc Criminal Proceedings
Disc Criminal Profiles
Disc Dementia
Disc Depression
Disc Depression and Aging
Disc Depressive Disorders
Disc Developmental Psychology
Disc Dysthemia
Disc Educational and developmental psychology
Disc Encephalitis
Disc Epilepsy
Disc Experimental Neurology
Disc Experimental Psychology
Disc Expert Witnesses
Disc Forensic Clinical Psychology
Disc Forensic Neuropsychology
Disc Forensic Psychology
Disc Forensic Psychology Practice
Disc Games psychology
Disc Health Behavior
Disc Health Psychology
Disc Hippocampus
Disc Human Factors Psychology
Disc Hydrocephalus
Disc Hypothalamus
Disc Industrial-Organizational Psychology
Disc Insanity Defense
Disc Intellectual Disability
Disc Legal Psychology
Disc Limbic System
Disc Lyme
Disc Manic Despondency
Disc Mental Illness and Violence
Disc Mental health
Disc Mindfullness Based Therapy
Disc Mood Disorder
Disc Mood Disorders
Disc Multiple Sclerosis
Disc Neural Model
Disc Neurocognative Disorders (NCDs)
Disc Neurodegenerative Disorders
Disc Neuroimaging
Disc Neurological Physiotherapy
Disc Neurological disorders
Disc Neuromuscular Disorders
Disc Neuropathy
Disc Neurosurgery
Disc Neurosurgical Emergencies
Disc Obsessive Compulsive Disorder
Disc Organizational Psychology
Disc Panic Attacks
Disc Paranormal Activity
Disc Parkinson's Disease
Disc Personality Psychology
Disc Pituitary
Disc Police Psychology
Disc Post Traumatic Disorders
Disc Posttraumatic Stress
Disc Pseudohypertrophic Myopathy
Disc Psychiatric Symptoms
Disc Psychiatric Treatment
Disc Psychiatry
Disc Psychiatry Diseases
Disc Psychiatry and Neurology
Disc Psycho Trauma
Disc Psychological Well Being
Disc Psychosocial Stress
Disc Psychotherapy
Disc Schizophrenia
Disc School psychology
Disc School psychology practice
Disc Seizure Disorder
Disc Sexual Sadism Disorder
Disc Shaking Palsy
Disc Social Anxiety Disorder
Disc Social Psychiatry
Disc Social cognitive psychology
Disc Spinal Cord
Disc Stress Disorder
Disc Stroke Disorder
Disc Suicidal Behavior
Disc Suicidal Thoughts
Disc Traumatic Brain Injury
Disc Trial Consultant
 
Recommended Journals
Disc Neuropsychiatry Journal
Disc Acta Psychopathologica
Disc Forensic Psychology Journal
Disc Experimental Psychology Journal
Disc School Cognitive Psychology Journal
Disc Neurology & Neurophysiology Journal
Disc Neurological Disorders Journal
Disc Brain Disorders Journal
Disc Psychiatry Journal
  View More»
 
Recommended Conferences
Disc Positive Psychology Conference
July 11-12, 2016 Philadelphia, USA
Disc  Neurorehabilitation Conference
July 21-22, 2016 Brisbane, Australia
Disc

7th Neurologists Meeting on Neurology and Neurosurgery


August 22-24 2016 Vienna, Austria

Disc 3rd Euro Psychiatry Conference
Sept 07-09, 2016 Amsterdam, The Netherlands
Disc

5th Alzheimer’s disease and Dementia Conference
September 29-October 01, 2016 London, UK

Disc 2nd Depression , Anxiety and Stress Management Meeting
Nov 03-04, 2016 Valencia, Spain
Disc 2nd Sleep Disorders Conference
Nov 28-30, 2016 Chicago, USA
Disc Counseling Psychology Conference
Dec 8-10, 2016 Seattle, USA
 
Article Tools
Disc Export citation
Disc Share/Blog this article
 
Article usage
  Total views: 11141
  [From(publication date):
July-2015 - May 31, 2016]
  Breakdown by view type
  HTML page views : 7401
  PDF downloads :3740
 
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

 
OMICS International Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
 
 
OMICS International Conferences 2016-17
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings
 
 

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

agrifoodaquavet@omicsinc.com

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

clinical_biochem@omicsinc.com

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

business@omicsinc.com

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

chemicaleng_chemistry@omicsinc.com

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

environmentalsci@omicsinc.com

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

engineering@omicsinc.com

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

generalsci_healthcare@omicsinc.com

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

genetics_molbio@omicsinc.com

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

immuno_microbio@omicsinc.com

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

omics@omicsinc.com

1-702-714-7001Extn: 9039

Materials Science Journals

Rachle Green

materialsci@omicsinc.com

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

mathematics_physics@omicsinc.com

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

medical@omicsinc.com

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

neuro_psychology@omicsinc.com

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

pharma@omicsinc.com

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

social_politicalsci@omicsinc.com

1-702-714-7001 Extn: 9042

 
© 2008-2016 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version