抗癫痫药物诱发攻击行为机制的研究进展  

Research progress on the mechanism of aggressive behavior induced by antiepileptic drugs

作　　者：侯红玲 张新江[1] 陶丽红 孙国先 Hou Hongling;Zhang Xinjiang;Tao Lihong;Sun Guoxian(Department of Neurology,Affiliated Hospital of Yangzhou University,Yangzhou 225001,China;Department of Pharmacy,Affiliated Hospital of Yangzhou University,Yangzhou 225001,China)

机构地区：[1]扬州大学附属医院神经内科,225001 [2]扬州大学附属医院药剂科,225001

出　　处：《中国医师杂志》2020年第7期1109-1115,共7页Journal of Chinese Physician

摘　　要：癫痫治疗以药物为主,但抗癫痫药物的使用通常受到不良反应的限制,如精神行为不良反应,包括攻击行为.具有不同作用机制的左乙拉西坦、吡仑帕奈和托吡酯均与攻击行为有关.目前,还没有证据表明,左乙拉西坦、吡仑帕奈和托吡酯增加攻击行为发病的具体药理机制.5-羟色胺和γ-氨基丁酸,特别是谷氨酸(通过AMPA受体)似乎起着关键作用.其他机制涉及激素、表观遗传学和另类精神病等.潜在的神经和(或)精神健康障碍易增加攻击行为敏感性.抗癫痫药物引起的不良反应越来越受关注,了解抗癫痫药物诱发攻击行为的风险因素和潜在机制,可能帮助临床医师尽早识别并管理降低这种不良反应,本文将可能机制进行阐述.Antiepileptic drugs(AEDs)are the main treatments of epilepsy,but their use is usually limited by adverse reactions,among them psychiatric and behavioral ones including aggressive behavior.Levetiracetam,perampanel,and topiramate,which have diverse mechanisms of action,have been associated with aggressive behavior.5-HT andγ-aminobutyric acid(GABA),especially glutamate[viaα-amino-3-hydroxy-5-methyl-4-isoxazole-propionate receptor(AMPA)receptor]seem to play key roles.Other mechanisms involve hormones,epigenetics and alternative psychosis.Neurological and/or mental health disorders tend to increase aggressive behavior sensitivity.The adverse reactions caused by AEDs are getting more and more attention.Clinicians may identify and manage this side effect as early as possible,if the risk factors and underlying mechanisms of aggressive behavior induced by antiepileptic we find.This article will explain the possible mechanisms.

关 键 词：抗癫痫药物 攻击行为 左乙拉西坦 吡仑帕奈 托吡酯 

分 类 号：R742.1[医药卫生—神经病学与精神病学]