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Ding W, Wang L, Li L, Li H, Wu J, Zhang J, Wang J. Pathogenesis of depression and the potential for traditional Chinese medicine treatment. Front Pharmacol 2024; 15:1407869. [PMID: 38983910 PMCID: PMC11231087 DOI: 10.3389/fphar.2024.1407869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/05/2024] [Indexed: 07/11/2024] Open
Abstract
Depression is a prevalent mental disorder that significantly diminishes quality of life and longevity, ranking as one of the primary causes of disability globally. Contemporary research has explored the potential pathogenesis of depression from various angles, encompassing genetics, neurotransmitter systems, neurotrophic factors, the hypothalamic-pituitary-adrenal axis, inflammation, and intestinal flora, among other contributing factors. In addition, conventional chemical medications are plagued by delayed onset of action, persistent adverse effects, and restricted therapeutic efficacy. In light of these limitations, the therapeutic approach of traditional Chinese medicine (TCM) has gained increasing recognition for its superior effectiveness. Numerous pharmacological and clinical studies have substantiated TCM's capacity to mitigate depressive symptoms through diverse mechanisms. This article attempts to summarize the mechanisms involved in the pathogenesis of depression and to describe the characteristics of herbal medicines (including compounded formulas and active ingredients) for the treatment of depression. It further evaluates their effectiveness by correlating with the multifaceted pathogenesis of depression, thereby furnishing a reference for future research endeavors.
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Affiliation(s)
- Weixing Ding
- College of Traditional Chinese Medicinal Material, Jilin Agricultural University, Changchun, China
| | - Lulu Wang
- School of Medicine, Changchun Sci-Tech University, Changchun, China
| | - Lei Li
- College of Traditional Chinese Medicinal Material, Jilin Agricultural University, Changchun, China
| | - Hongyan Li
- College of Traditional Chinese Medicinal Material, Jilin Agricultural University, Changchun, China
| | - Jianfa Wu
- College of Traditional Chinese Medicinal Material, Jilin Agricultural University, Changchun, China
| | - Jing Zhang
- College of Traditional Chinese Medicinal Material, Jilin Agricultural University, Changchun, China
- Jilin Provincial International Joint Research Center for the Development and Utilization of Authentic Medicinal Materials, Changchun, China
| | - Jing Wang
- Jilin Province Faw General Hospital, Changchun, China
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Nadeem MD, Memon S, Qureshi K, Farooq U, Memon UA, Aparna F, Kachhadia MP, Shahzeen F, Ali S, Varrassi G, Kumar L, Kumar S, Kumar S, Khatri M. Seizing the Connection: Exploring the Interplay Between Epilepsy and Glycemic Control in Diabetes Management. Cureus 2023; 15:e45606. [PMID: 37868449 PMCID: PMC10588297 DOI: 10.7759/cureus.45606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Epilepsy, a neurological disorder characterized by recurrent seizures, and diabetes, a metabolic disorder characterized by impaired regulation of glucose levels, are two distinct conditions that may appear unrelated at first glance. Nevertheless, recent scholarly investigations have revealed these entities' intricate and ever-evolving interplay. This review initially delves into the intricate interplay between epilepsy and its potential ramifications on glycemic control. Seizures, particularly those accompanied by convulsive manifestations, have the potential to induce acute perturbations in blood glucose levels via diverse mechanisms, encompassing the liberation of stress hormones, the emergence of insulin resistance, and the dysregulation of the autonomic nervous system. Comprehending these intricate mechanisms is paramount in customizing productive strategies for managing diabetes in individuals with epilepsy. On the contrary, it is worth noting that diabetes can substantially impact the trajectory and control of epilepsy. The correlation between hyperglycemia and an elevated susceptibility to seizures, as well as the potential for exacerbating the intensity of epilepsy, has been established. This narrative review offers a concise exposition of the intricate interplay between epilepsy and glycemic control within diabetes management. The objective of exploring reciprocal influences, underlying mechanisms, and common risk factors is to augment the clinical comprehension of this intricate interconnection. In essence, this acquired knowledge possesses the potential to serve as a guiding compass for healthcare professionals, enabling them to craft bespoke therapeutic approaches that enhance the holistic welfare of individuals grappling with the coexistence of epilepsy and diabetes.
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Affiliation(s)
| | - Siraj Memon
- Medicine, Liaquat University of Medical & Health Sciences, Jamshoro, PAK
| | - Kashifa Qureshi
- Medicine, Liaquat University of Medical & Health Sciences, Jamshoro, PAK
| | - Umer Farooq
- Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Unaib Ahmed Memon
- Neurology and Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Fnu Aparna
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | | | - Fnu Shahzeen
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Sameer Ali
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | | | - Lakshya Kumar
- General Medicine, Pandit Deendayal Upadhyay Medical College, Rajkot, IND
| | - Sumeet Kumar
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
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Miziak B, Czuczwar SJ, Pluta R. Comorbid epilepsy and depression—pharmacokinetic and pharmacodynamic drug interactions. Front Pharmacol 2022; 13:988716. [PMID: 36278185 PMCID: PMC9585163 DOI: 10.3389/fphar.2022.988716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
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).
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Affiliation(s)
- Barbara Miziak
- Department of Pathophysiology, Medical University, Lublin, Poland
| | - Stanisław J. Czuczwar
- Department of Pathophysiology, Medical University, Lublin, Poland
- *Correspondence: Stanisław J. Czuczwar, ; Ryszard Pluta,
| | - Ryszard Pluta
- Laboratory of Ischemic and Neurodegenerative Brain Research, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
- *Correspondence: Stanisław J. Czuczwar, ; Ryszard Pluta,
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Feng HX, Wang MX, Zhao HM, Hou XX, Xu B, Gui Q, Wu GH, Dong XF, Xu QR, Shen MQ, Shi QR, Cheng QZ, Xue SR. Effect of cognitive behavioral intervention on anxiety, depression, and quality of life in patients with epilepsy. Am J Transl Res 2022; 14:5077-5087. [PMID: 35958485 PMCID: PMC9360885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect of cognitive behavioral therapy (CBT) on quality of life, anxiety, and depression in patients with epilepsy. METHODS Each study subject was randomly assigned to a CBT (n=46) or control (n=49) group (1:1 ratio), and the first group underwent an 8-week CBT treatment. Anxiety, depression, and quality of life (QOLIE-31) were assessed at both baseline and endpoint using the Self-Rating Anxiety Scale (SAS), Hamilton Depression Scale (HDMA) and quality of life in Epilepsy-31 (QOLIE-31) scales. The statistical analyses included between-and within-group comparisons of the effects of CBT on these measures and associations with demographic and clinical variables. RESULTS No differences were found between variables at baseline (P>0.05). The repeated-measures analyses found that CBT group had greater improvement in depression score compared to the control group (P<0.05). The analysis of anxiety score showed that compared to the control group, CBT intervention had no statistical significance in the total anxiety population. However, the CBT intervention decreased anxiety in women and Combined-drug group (P<0.05). The CBT group had greater improvement in overall score, medication effect, and seizure worry score than the control group (P<0.05). Stratified analysis found total and medication effects score of CBT intervention group for the combined-drug group were higher than those of the single drug group (P<0.05). CONCLUSION Increases in overall scores, seizure worry, cognitive functioning, and medication effect were better in the CBT group. CBT can improve anxiety, depression, and quality of life in patients with epilepsy. Women and combined-drug patients with epilepsy benefit most from CBT.
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Affiliation(s)
- Hong-Xuan Feng
- Department of Neurology, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Mei-Xia Wang
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Hui-Min Zhao
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Xiao-Xia Hou
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Bo Xu
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Qian Gui
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Guan-Hui Wu
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Xiao-Feng Dong
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Qin-Rong Xu
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Ming-Qiang Shen
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Qian-Ru Shi
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Qing-Zhang Cheng
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital)Suzhou 215002, Jiangsu, China
| | - Shou-Ru Xue
- Department of Neurology, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
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