Potential of levetiracetam in mood disorders - A preliminary review
Potential of levetiracetam in mood disorders - A preliminary review
复制标题
DOI：
10.2165/00023210-200620120-00002
复制
发表时间：
2006-01-01
期刊：
影响因子：
6
通讯作者：
Bhagwagar, Zubin
中科院分区：
文献类型：
--
作者：
Muralidharan, Anjana;Bhagwagar, Zubin
左乙拉西坦是一种较新的抗癫痫药物，于1999年首次被美国FDA批准用于治疗成人难治性部分性癫痫。从那时起，它已被批准用于更广泛的患者人群，即作为> 4岁患者部分性癫痫发作的预防治疗（全球）和作为> 16岁患者部分性癫痫发作的一线单药治疗（欧洲）;以及作为青少年肌阵挛性癫痫发作的预防治疗（欧洲和美国）。它具有良好的药代动力学特征，似乎作用于CNS中的特定部位。药效学证据表明左乙拉西坦间接促进GABA能功能，越来越多的证据表明GABA在心境障碍的病理生理学中发挥重要作用。使用抑郁症、焦虑症和躁狂症动物模型的临床前研究为左乙拉西坦作为情绪稳定剂提供了证据。来自病例报告和开放标签试点研究的初步临床证据表明，该药物作为添加治疗和单药治疗，在广泛的双相谱系障碍中具有疗效。最近，在一项开放标签试验中，在基线时处于抑郁期并接受左乙拉西坦作为添加治疗8周的双相情感障碍患者中报告了31%的缓解率。虽然这些结果是令人鼓舞的，安慰剂对照数据需要进一步澄清左乙拉西坦在治疗情绪障碍的作用。
Levetiracetam is a newer antiepileptic agent that was first approved by the US FDA in 1999 as an adjunctive therapy for the treatment of refractory partial epilepsy in adults. Since then, it has been approved for a wider patient population, i.e. as adjunctive therapy for partial seizures in patients > 4 years of age (worldwide) and as first-line monotherapy for partial seizures in patients > 16 years of age (in Europe); and as adjunctive therapy for juvenile myoclonic seizures (in Europe and the US). It has a favourable pharmacokinetic profile and appears to act at a specific site in the CNS. Pharmacodynamic evidence indicates that levetiracetam indirectly facilitates GABAergic function, and an increasing body of evidence suggests an important role for GABA in the pathophysiology of mood disorders. Preclinical studies using animal models of depression, anxiety and mania provide evidence for levetiracetam as a mood stabiliser. Preliminary clinical evidence from case reports and open-label pilot studies indicates that the drug, both as add-on therapy and as monotherapy, has efficacy in a wide range of bipolar spectrum disorders. Most recently, a 31% remission rate was reported in patients with bipolar disorder who were in the depressed phase at baseline and who received levetiracetam as add-on therapy for 8 weeks in an open-label trial. While these results are encouraging, placebo-controlled data are needed to further clarify the role of levetiracetam in the treatment of mood disorders.