PharmatecaPharmatecaФарматека2073-40342414-9128Bionika Media289169ArticlesСтатьиReview ArticleINFLUENCE OF ANTIEPILEPTIC DRUGS ON MOOD AND BEHAVIOR OF THE PATIENTS WITH EPILEPSYВЛИЯНИЕ ПРОТИВОЭПИЛЕПТИЧЕСКИХ ПРЕПАРАТОВ НА НАСТРОЕНИЕ И ПОВЕДЕНИЕ ПАЦИЕНТОВ С ЭПИЛЕПСИЕЙBelousovaE. DБелоусоваЕ. Д

MD, Prof., Honored Doctor of the Russian Federation, Department of Psychoneurology and Epileptology

д.м.н., проф., заслуженный врач РФ, отдел психоневрологии и эпилептологии

ebelousova@inbox.ruASS Scientific Research Clinical Institute of Pediatrics n.a. Yu.E. VeltischevОСП «Научно-исследовательский клинический институт педиатрии им. Ю. Е. Вельтищева»FSBEI HE RNSMU n.a. N.I. Pirogov of RMHФГБОУ ВО РНИМУ им. Н.Н. Пирогова Минздрава РФФГБОУ ВО РНИМУ им. Н.Н. Пирогова Минздрава РФ100720162313NO13 (2016)№13 (2016)151826022023Copyright ©; 2016, Bionika MediaCopyright ©; 2016, ООО «Бионика Медиа»2016Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2073-4034/article/view/289169

Experimental and clinical data demonstrate that antiepileptic drugs (AEDs) in addition to anticonvulsive effect can modulate the mood and behavior of the patients with epilepsy. Therapeutic targets may be common - interference with the metabolism of y-aminobutyric acid and neurotransmitters, and also with the function of ion channels of brain. Some AEDs have a specific influence that should be considered for the selection of therapy. Effects on behavior and mood can be multidirectional. Positive effects (for example, with the use of valproate) have long been used not only in neurology but also in psychiatry. Adverse effects (they are regarded as adverse events) can be avoided by awareness on risk groups for their development, or by minimization the degree of severity with decrease in the dose. The review presents modern data on the effect of specific AEDs on the behavior and mood of patients with epilepsy. A more precise definition of psychotropic profile of AEDS will lead to greater individualization of treatment and possibly to the definition of a new strategy of treatment of psychiatric conditions.

Экспериментальные и клинические данные демонстрируют, что помимо противосудорожного эффекта противоэпилептические препараты (ПЭП) могут модулировать настроение и поведение пациентов с эпилепсией. При этом мишени воздействия могут быть общими - вмешательство в метаболизм Y-аминомасляной кислоты и нейротрансмиттеров, а также в функции ионных каналов головного мозга. Некоторые ПЭП обладают специфическим влиянием, которое необходимо учитывать в выборе терапии. Влияние на поведение и настроение может быть разнонаправленным. Позитивные эффекты (например, при применении вальпроата) уже давно используются не только в неврологии, но и в психиатрии. Побочных эффектов (они расцениваются как нежелательные явления) можно избежать, зная группы риска по их развитию, или минимизировать степень их выраженности снижением дозы препарата. В обзоре приведены современные данные по влиянию конкретных ПЭП на поведение и настроение пациентов с эпилепсией. Более точное определение психотропного профиля ПЭП приведет к большей индивидуализации лечения и, возможно, к определению новой стратегии лечения психиатрических состояний.

epilepsytreatmentantiepileptic drugstolerabilitybehaviormoodэпилепсиялечениепротивоэпилептические препаратыпереносимостьповедениенастроениеPerucca P., Mula M. Antiepileptic drug effects on mood and behavior: Molecular targets. Epilepsy & Behavior. 2013;26:440-49.Perucca P, Carter J, Vahle V, Gilliam F.G. Adverse antiepileptic drug effects: toward a clinically and neurobiologically relevant taxonomy. Neurology. 2009;72:1223-29.Ettinger A.B. Psychotropic effects of antiepileptic drugs. Neurology. 2006;67:1916-25.Mula M., Pini S., Cassano G.B. The role of anticonvulsant drugs in anxiety disorders: a critical review of the evidence. J. Clin. Psychopharmacol. 2007;27:263- 72.Spina E., Perugi G. Antiepileptic drugs: indications other than epilepsy. Epileptic. Disord. 2004; 6:57-75.Mula M., Sander J.W. Negative effects of antiepileptic drugs on mood in patients with epilepsy. Drug. Saf. 2007;30:555-67.Sanacora G., Saricicek A. GABAergic contributions to the pathophysiology of depression and the mechanism of antidepressant action. CNS Neurol. Disord. Drug. Targets. 2007;6:127-40.Comai S., Tau M., Gobbi G. Thepsychopharmacology of aggressive behavior: a translational approach: part 1: neurobiology. J. Clin. Psychopharmacol. 2012;32:83-94.Loring D.W., Marino S., Meador K.J. Neuropsychological and behavioral effects of antiepilepsy drugs. Neuropsychol. Rev. 2007;17:413-25.Hauser P, Devinsky O., De Bellis M., Theodore W.H., Post R.M. Benzodiazepine withdrawal delirium with catatonic features. Occurrence in patients with partial seizure disorders. Arch. Neurol. 1989;46:696-99.Kendell S.F, Krystal J.H., Sanacora G. GABA and glutamate systems as therapeutic targets in depression and mood disorders. Expert. Opin. Ther. Targets. 2005;9:153-68.Bagley J, Moghaddam B. Temporal dynamics of glutamate efflux in the prefrontal cortex and in the hippocampus following repeated stress: effects of pretreatment with saline or diazepam. Neuroscience. 1997;77:65- 73.Nowak G, Ordway G.A., Paul i.A. Alterations in the N-methyl-D-aspartate (NMDA) receptor complex in the frontal cortex of suicide victims. Brain Res. 1995;675:157-64.Mendels J, Frazer A. Alterations in cell membrane activity in depression. Am. J. Psychiatry. 1974;131:1240-46.El-Mallakh R.S., Huff M.O. Mood stabilizers and ion regulation. Harv. Rev. Psychiatry. 2001;9:23-32.Farber N.B., Jiang X.P, Heinkel C., Nemmers B. Antiepileptic drugs and agents that inhibit voltage-gated sodium channels prevent NMDA antagonist neurotoxicity. Mol. Psychiatry. 2002;7:726-33.Bhat S, Dao D.I., Terrillion C.E., et al. CACNA1C (Ca(v)1.2) in the pathophysiology of psychiatric disease. Prog. Neurobiol. 2012;99:1-14.Galeotti N, Bartolini A., Ghelardini C. Blockade of intracellular calcium release induces an antidepressant-like effect in the mouse forced swimming test. Neuropharmacology. 2006;50:309-16.Grunze H.C. Anticonvulsants in bipolar disorder. J. Ment. Health. 2010;19:127-41.Bond D.J., Lam R.W., Yatham L.N. Divalproex sodium versus placebo in the treatment of acute bipolar depression: a systematic review and metaanalysis. J. Affect. Disord. 2010;124:228-34.Lindenmayer J.P., Kotsaftis A. Use of sodium valproate in violent and aggressive behaviors: a critical review. J. Clin. Psychiatry. 2000;61:123-28.Levinson D.F, Devinsky O. Psychiatric adverse events during vigabatrin therapy. Neurology. 1999 22;53(7):1503-11.Ferrie C.D., Robinson R.O., Panayiotopoulos C.P. Psychotic and severe behavioural reactions with vigabatrin: a review. Acta. Neurol. Scand. 1996;93:1-8.Thomas L., Trimble M., Schmitz B., Ring H. Vigabatrin and behaviour disorders: a retrospective survey. Epilepsy Res. 1996;25:21-7.McElroy S.L., Suppes T., Keck P.E. Jr, Black D., Frye M.A., Altshuler L.L., Nolen W.A., Kupka R.W., Leverich G.S., Walden J., Grunze H., Post R.M. Open-label adjunctive zonisamide in the treatment of bipolar disorders: a prospective trial. J. Clin. Psychiatry. 2005;66:617-24.Dauphinais D., Knable M., Rosenthal J., Polanski M., Rosenthal N. Zonisamide for bipolar disorder, mania or mixed states: a randomized, double blind, placebo-controlled adjunctive trial. Psychopharmacol. Bull. 2011;44:5-17.White J.R., Walczak T.S., Marino S.E., Beniak T.E., Leppik I.E., Birnbaum A.K. Zonisamide discontinuation due to psychiatric and cognitive adverse events: a case-control study. Neurology. 2010;75:513-18.Инструкция по применению карбамазепина. РЛС. 2015;491.Frye M.A. Clinical practice. Bipolar disorder - a focus on depression. N. Engl. J. Med. 2011;364:51-9.Ettinger A.B., Kustra R.P, Hammer A.E. Effect of lamotrigine on depressive symptoms in adult patients with epilepsy. Epilepsy Behav. 2007;10:148-54.Reich D.B., Zanarini M.C., Bieri K.A. A preliminary study of lamotrigine in the treatment of affective instability in borderline personality disorder, int. Clin. Psychopharmacol. 2009;24:270-75.Mula M., Trimble M.R., Yuen A., Liu R.S., Sander J.W. Psychiatric adverse events during levetiracetam therapy. Neurology. 2003;61:704-6.Hemstaedter C., Mihov Y., Toliat M.R. Genetic variation in dopaminergic activity is associated with the risk for psychiatric side effects of levetiracetam. Epilepsia. 2013;54(1):36-44.Ettinger A.B., LoPresti A., Yang H., et al. Psychiatric and behavioral adverse events in randomized clinical studies of the noncompetitive AMPA receptor antagonist perampanel. Epilepsia. 2015;56(8):1252-63.Zaccara G., Gangemi P., Perucca P, Specchio L. The adverse event profile of pregabalin: a systematic review and meta-analysis of randomized controlled trials. Epilepsia. 2011;52:826-36.Wheless J.W., Conry J., Krauss G., Mann A., LoPresti A., Narurkar M. Safety and tolerability of rufinamide in children with epilepsy: a pooled analysis of 7 clinical studies. J. Child. Neurol. 2009;24:1520-25.Mula M., Trimble M.R., Lhatoo S.D., Sander J.W. Topiramate and psychiatric adverse events in patients with epilepsy. Epilepsia. 2003;44:659-63.Mowla A., Kardeh E. Topiramate augmentation in patients with resistant major depressive disorder: a double-blind placebo-controlled clinical trial. Prog. Neuropsychopharmacol. Biol. Psychiatry. 2011;35:9 70- 73.Mula M., Cavanna A.E., Monaco F. Psychopharmacology of topiramate: from epilepsy to bipolar disorder. Neuropsychiatr. Dis. Treat. 2006;2:475-88.Roger J., Grangeon H., Gueyj J., Lob H. Psychiatric and psychologic effects ofethosuximide treatment of epileptics. Encéphale. 1968;57:407-38.