癫痫中的抑郁症：基于多模式发病机制的药物和非药物干预
Depression in Epilepsy: Drug and Non-Drug Interventions Based on Multimodal Pathogenesis.
摘要(中文译文)
抑郁症是癫痫患者常见的共病，显著影响其生活质量。然而，癫痫伴发抑郁症的精确机制仍不清楚。本综述综合了关于癫痫中抑郁症发病机制的最新研究，重点关注单胺类神经递质异常、神经炎症、下丘脑-垂体-肾上腺（HPA）轴功能障碍、神经营养因子、线粒体功能障碍及氧化应激等方面。文章探讨了抗抑郁药与抗癫痫药物（AEDs）在癫痫伴抑郁症治疗中的双重作用，重点介绍了可能加重抑郁或癫痫发作活动的药物。强调了需要更精细的治疗策略，包括谨慎选择抗抑郁药和AEDs。此外，还综述了非药物干预措施，如认知行为疗法（CBT）、神经调控技术及饮食调整（抗炎和抗氧化食物），作为药物治疗的重要辅助手段。本文旨在指导临床医生选择最佳治疗策略，并强调对癫痫伴抑郁症患者进行及时抑郁筛查、长期管理和个体化治疗的重要性。
Abstract
Depression is a common comorbidity in patients with epilepsy, significantly impacting their quality of life. However, the precise mechanisms underlying depression in epilepsy remain unclear. This review synthesizes the latest research on the pathogenesis of depression in epilepsy, focusing on abnormalities in monoamine neurotransmitters, neuroinflammation, HypothalamicPituitary-Adrenal (HPA) axis dysfunction, neurotrophic factors, mitochondrial dysfunction, and oxidative stress. The article explores the dual roles of antidepressants and antiepileptic drugs (AEDs) in the treatment of depression in epilepsy, highlighting drugs that may exacerbate either depression or seizure activity. The need for more nuanced treatment strategies, including the careful selection of antidepressants and AEDs, is emphasized. Additionally, non-drug interventions, such as Cognitive-Behavioral Therapy (CBT), neuromodulation techniques, and dietary modifications (anti-inflammatory and antioxidant foods), are reviewed as vital adjuncts to pharmacological treatments. This article aims to guide clinicians in choosing optimal treatment strategies and underscores the importance of timely depression screening, long-term management, and personalized therapy for patients with epilepsy and comorbid depression.
如何引用
AMA
Qingyang Zhan, Fanyi Kong, Yijie Liu, Tuersun Reyila, Qiuyuan Fu, Jijun Wang, et al. Depression in Epilepsy: Drug and Non-Drug Interventions Based on Multimodal Pathogenesis.. Current neuropharmacology. 2026; doi:10.2174/011570159X470565260626215219.
APA
Qingyang Zhan, Fanyi Kong, Yijie Liu, Tuersun Reyila, Qiuyuan Fu, Jijun Wang, et al (2026). Depression in Epilepsy: Drug and Non-Drug Interventions Based on Multimodal Pathogenesis.. Current neuropharmacology. https://doi.org/10.2174/011570159X470565260626215219
GB/T 7714
Qingyang Zhan, Fanyi Kong, Yijie Liu, Tuersun Reyila, Qiuyuan Fu, Jijun Wang, et al. Depression in Epilepsy: Drug and Non-Drug Interventions Based on Multimodal Pathogenesis.[J]. Current neuropharmacology, 2026 doi:10.2174/011570159X470565260626215219.
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