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Review
. 2022 Oct 7:13:988716.
doi: 10.3389/fphar.2022.988716. eCollection 2022.

Comorbid epilepsy and depression-pharmacokinetic and pharmacodynamic drug interactions

Barbara Miziak  1 , Stanisław J Czuczwar  1 , Ryszard Pluta  2
Affiliations
Review

Comorbid epilepsy and depression-pharmacokinetic and pharmacodynamic drug interactions

Barbara Miziak et al. Front Pharmacol. .

Abstract

Background: Major depressive disorder may be encountered in 17% of patients with epilepsy and in patients with drug-resistant epilepsy its prevalence may reach 30%. This indicates that patients with epilepsy may require antidepressant treatment. Purpose: Both pharmacodynamic and pharmacokinetic interactions between antiepileptic (antiseizure) and antidepressant drugs have been reviewed. Also, data on the adverse effects of co-administration of antiepileptic with antidepressant drugs have been added. This article was submitted to Neuropharmacology, a section of the journal Frontiers in Pharmacology. Methods: The review of relevant literature was confined to English-language publications in PUBMED databases. Table data show effects of antidepressants on the seizure susceptibility in experimental animals, results of pharmacodynamic interactions between antiepileptic and antidepressant drugs mainly derived from electroconvulsions in mice, as well as results concerning pharmacokinetic interactions between these drugs in clinical conditions. Conclusion: Antidepressant drugs may exert differentiated effects upon the convulsive threshold which may differ in their acute and chronic administration. Animal data indicate that chronic administration of antidepressants could reduce (mianserin, trazodone) or potentiate the anticonvulsant activity of some antiepileptics (fluoxetine, reboxetine, venlafaxine). There are also examples of neutral interactions (milnacipran).

Keywords: antidepressant drugs; antiepileptic drugs (AEDs); depression; epilepsy; pharmacodynamic interactions; phrmacokinetic interactions; seizures.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Alhashimi R., Thoota S., Ashok T., Palyam V., Azam A. T., Odeyinka O., et al. (2022). Comorbidity of epilepsy and depression: Associated pathophysiology and management. Cureus 14 (1), e21527. 10.7759/cureus.21527 - DOI - PMC - PubMed
    1. Auerbach D. S., Biton Y., Polonsky B., McNitt S., Gross R. A., Dirksen R. T., et al. (2018). Risk of cardiac events in long QT syndrome patients when taking antiseizure medications. Transl. Res. 191, 81–92. 10.1016/.e7j.trsl.2017.10.002 - DOI - PMC - PubMed
    1. Banach M., Popławska M., Błaszczyk B., Borowicz K. K., Czuczwar S. J. (2016). Pharmacokinetic/pharmacodynamic considerations for epilepsy - depression comorbidities.. Expert Opin. Drug Metab. Toxicol. 12 (9), 1067–1080. 10.1080/17425255.2016.1198319 - DOI - PubMed
    1. Barczyński B., Buszewicz G., Łuszczki J. J., Bańka K., Tutaj K., Mróz T., et al. (2011). Low dose of bupropion significantly enhances the anticonvulsant activity of felbamate, lamotrigine and topiramate in mice. Eur. J. Pharmacol. 650 (2-3), 550–555. 10.1016/j.ejphar.2010.10.039 - DOI - PubMed
    1. Borowicz K. K., Banach M., Piskorska B., Czuczwar S. J. (2013). Effect of acute and chronic tianeptine on the action of classical antiepileptics in the mouse maximal electroshock model. Pharmacol. Rep. 65 (2), 379–388. 10.1016/s1734-1140(13)71013-2 - DOI - PubMed

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