Skip to main content
SpringerLink
Log in
Book cover

Polypharmacy in Psychiatry Practice, Volume I pp 233–242Cite as

Stress Sensitization and Anticonvulsant Medication in Psychiatric Patients

  • Chapter
  • First Online:

  • 1210 Accesses

Abstract

Recent reported findings indicate that stress experiences are related to psychological and neurobiological processes that may have lasting consequences and significantly influence brain functions. Cognitive and emotional dysregulation related to traumatic stress is likely linked to deficits in inhibitory functions and increased limbic excitability that may lead to temporo-limbic seizure-like activity. These findings strongly suggest that stress-activated limbic kindling may be involved in the pathogenesis of depression, posttraumatic stress disorder (PTSD), schizophrenia and other psychiatric disorders which may explain efficacy of antiepileptic drugs in their treatment.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Abbreviations

ACC:

Anterior Cingulate Cortex

BDNF:

Brain Derived Neurotrophic Factor

EEG:

Electroencephalograph

GABA:

Gamma-Aminobutyric Acid

LSCL-33:

Limbic System Checklist

PTSD:

Posttraumatic Stress Disorder

References

  1. Teicher MH, Andersen SL, Polcari A, Anderson CM, Navalta CP, Kim DM (2003) The neurobiological consequences of early stress and childhood maltreatment. Neurosci Biobehav Rev 27:33–44

    Article  PubMed  Google Scholar 

  2. Bogdan R, Pizzagalli DA (2006) Acute stress reduces reward responsiveness: implications for depression. Biol Psychiatry 60:1147–1154

    Article  PubMed  Google Scholar 

  3. Cole DA, Nolen-Hoeksema S, Girgus J, Paul G (2006) Stress exposure and stress generation in child and adolescent depression: a latent trait-state-error approach to longitudinal analyses. J Abnorm Psychol 115:40–51

    Article  PubMed  Google Scholar 

  4. Teicher MH, Tomoda A, Andersen SE (2006) Neurobiological consequences of early stress and childhood maltreatment: are results from human and animal studies comparable? Ann N Y Acad Sci 1071:313–323

    Article  PubMed  Google Scholar 

  5. McCrory E, De Brito SA, Viding E (2010) Research review: the neurobiology and genetics of maltreatment and adversity. J Child Psychol Psychiatry 51:1079–1095

    Article  PubMed  Google Scholar 

  6. Bremner JD (2006) Stress and brain atrophy. CNS Neurol Disord Drug Targets 5:503–512

    Article  PubMed  Google Scholar 

  7. Duman RS, Monteggia LM (2006) A neurothrophic model for stress-related mood disorders. Biol Psychiatry 59:1116–1127

    Article  PubMed  CAS  Google Scholar 

  8. Post RM, Weis SR, Smith MA (1995) Sensitization and kindling. In: Friedman MJ, Charney DS, Deutch AY (eds) Neurobiological and clinical consequences of stress: from normal adaptation to posttraumatic stress disorder. Lipincott-Raven, Philadelphia

    Google Scholar 

  9. Post RM, Weiss RB (1998) Sensitization and kindling phenomena in mood, anxiety, and obsessivecompulsive disorders: the role of serotonergic mechanisms in illness progression. Biol Psychiatry 44:193–206

    Article  PubMed  CAS  Google Scholar 

  10. Kraus JE (2000) Sensitization phenomena in psychiatric illness: lessons from the kindling model. J Neuropsychiatry Clin Neurosci 12:328–343

    Article  PubMed  CAS  Google Scholar 

  11. Teicher MH, Glod CA, Surrey J, Swett C Jr (1993) Early childhood abuse and limbic system ratings in adult psychiatric outpatients. J Neuropsychiatry Clin Neurosci 5:301–306

    PubMed  CAS  Google Scholar 

  12. Putnam F (1997) Dissociation in children and adolescents. A developmental perspective. The Guilford Press, London

    Google Scholar 

  13. Ito Y, Teicher M, Gold C, Harper D, Magnus E, Gelbard H (1993) Increased prevalence of electrophysiological abnormalities in children with psychological, physical and sexual abuse. J Neuropsychiatry Clin Neurosci 5:401–408

    PubMed  CAS  Google Scholar 

  14. Spigelman I, Li Z, Banerjee PK, Mihalek RM, Homanics GE, Olsen RW (2002) Behavior and physiology of mice lacking the GABAA-receptor delta subunit. Epilepsia 43:3–8

    Article  PubMed  CAS  Google Scholar 

  15. Heath RG (1976) Brain function in epilepsy: midbrain, medullary, and cerebellar interaction with the rostral forebrain. J Neurol Neurosurg Psychiatry 39:1037–1051

    Article  PubMed  CAS  Google Scholar 

  16. Riklan M, Kabat C, Cooper IS (1976) Psychological effects of short term cerebellar stimulation in epilepsy. J Nerv Ment Dis 162:282–290

    Article  PubMed  CAS  Google Scholar 

  17. Schutter DLJG, van Honk J (2006) An electrophysiological link between the cerebellum, cognition and emotion: frontal theta EEG activity to single-pulse cerebellar TMS. Neuroimage 33:1227–1231

    Article  PubMed  Google Scholar 

  18. Silberman E, Post R, Nurenberger J, Theodore W, Boulenger J (1985) Transient sensory, cognitive, and affective phenomena in affective illness: a comparison with complex partial epilepsy. Br J Psychiatry 146:81–89

    Article  PubMed  CAS  Google Scholar 

  19. Roberts RJ, Gorman LL, Lee GP, Hines ME, Richardson ED, Riggle TA et al (1992) The phenomenology of multiple partial seizure like symptoms without stereotyped spells: an epilepsy spectrum disorder? Epilepsy Res 13:167–177

    Article  PubMed  CAS  Google Scholar 

  20. Hines M, Swan C, Roberts RJ, Varney NR (1995) Characteristics and mechanisms of epilepsy spectrum disorder: an explanatory model. Appl Neuropsychol 2:1–6

    Article  PubMed  CAS  Google Scholar 

  21. Post RM (1992) Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am J Psychiatry 149:999–1010

    PubMed  CAS  Google Scholar 

  22. Segal ZV, Williams JM, Teasdale JD, Gemar M (1996) A cognitive science perspective on kindling and episode sensitization in recurrent affective disorder. Psychol Med 26:371–380

    Article  PubMed  CAS  Google Scholar 

  23. Johannessen LC (2008) Antiepileptic drugs in non-epilepsy disorders: relations between mechanisms of action and clinical efficacy. CNS Drugs 22:27–47

    Article  Google Scholar 

  24. Post RM, Weiss SR, Pert A (1988) Implications of behavioral sensitization and kindling for stress induced behavioral change. Adv Exp Med Biol 245:441–463

    PubMed  CAS  Google Scholar 

  25. Varney NR, Garvey MJ, Cook BL, Campbell DA, Roberts RJ (1993) Identification of treatment-resistant depressives who respond favorably to carbamazepine. Ann Clin Psychiatry 5:117–122

    Article  PubMed  CAS  Google Scholar 

  26. Kaufman KR (2011) Antiepileptic drugs in the treatment of psychiatric disorders. Epilepsy Behav 21:1–11

    Article  PubMed  Google Scholar 

  27. Vigo DV, Baldessarini RJ (2009) Anticonvulsants in the treatment of major depressive disorder: an overview. Harv Rev Psychiatry 17:231–241

    Article  PubMed  Google Scholar 

  28. Bob P, Susta M, Gregusova A, Jasova D, Mishara A, Raboch J (2010) Traumatic stress, dissociation, and limbic irritability in patients with unipolar depression being treated with SSRIs. Psychol Rep 107:685–696

    Article  PubMed  Google Scholar 

  29. Bob P, Jasova D, Raboch J (2011) Subclinical epileptiform process in patients with unipolar depression and its indirect psychophysiological manifestations. PLoS One 6(11):e28041

    Article  PubMed  CAS  Google Scholar 

  30. Post RM, Weiss SR, Li H, Leverich GS, Pert A (1999) Sensitization components of post-traumatic stress disorder: implications for therapeutics. Semin Clin Neuropsychiatry 4:282–294

    PubMed  CAS  Google Scholar 

  31. Post RM, Weiss SRB, Smith M, Li H, McCann U (1997) Kindling versus quenching. Implications for the evolution and treatment of posttraumatic stress disorder. Ann N Y Acad Sci 821:285–295

    Article  PubMed  CAS  Google Scholar 

  32. Berlin HA (2007) Antiepileptic drugs for the treatment of post-traumatic stress disorder. Curr Psychiatry Rep 14:185–189

    Google Scholar 

  33. Roca V, Freeman TV (2002) Psychosensory symptoms in combat veterans with posttraumatic stress disorder. J Neuropsychiatry Clin Neurosci 14:185–189

    Article  PubMed  Google Scholar 

  34. Glenthoj BY, Hemmingsen R (1997) Dopaminergic sensitization: implications for the pathogenesis of schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 21:23–46

    Article  PubMed  CAS  Google Scholar 

  35. Stevens JR (1999) Epilepsy, schizophrenia and the extended amygdala. Ann N Y Acad Sci 156:548–561

    Article  Google Scholar 

  36. Grossman AW, Churchill JD, McKinney BC, Kodish IM, Otte SL, Greenough WT (2003) Experience effects on brain development: possible contributions to psychopathology. J Child Psychol Psychiatry 44:33–63

    Article  PubMed  Google Scholar 

  37. Tiihonen J, Wahlbeck K, Kiviniemi V (2009) The efficacy of lamotrigine in clozapine-resistant schizophrenia: a systematic review and meta-analysis. Schizophr Res 109:10–14

    Article  PubMed  Google Scholar 

  38. Bob P, Palus M, Susta M, Glaslova K (2010) Sensitization, epileptic-like symptoms and local synchronization in patients with paranoid schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 34:143–146

    Article  PubMed  Google Scholar 

  39. Adamec RE (1990) Does kindling model anything clinically relevant? Biol Psychiatry 27:249–279

    Article  PubMed  CAS  Google Scholar 

  40. Goddard GV (1967) Development of epileptic seizures through brain stimulation at low intensity. Nature 214:1020–1021

    Article  PubMed  CAS  Google Scholar 

  41. Stevens JR (2002) Schizophrenia: reproductive hormones and the brain. Am J Psychiatry 159:713–719

    Article  PubMed  Google Scholar 

  42. Heckers S, Konradi C (2002) Hippocampal neurons in schizophrenia. J Neural Transm 109:891–905

    Article  PubMed  CAS  Google Scholar 

  43. Möhler H (2006) GABAA receptor diversity and pharmacology. Cell Tissue Res 326:505–516

    Article  PubMed  Google Scholar 

  44. Benes FM, Berretta S (2001) GABAergic interneurons: implications for understanding schizophrenia and bipolar disorder. Neuropsychopharmacology 25:1–27

    Article  PubMed  CAS  Google Scholar 

  45. Costa E, Davis JM, Dong E, Grayson DR, Guidotti A, Tremolizzo L et al (2004) A GABAergic cortical deficit dominates schizophrenia pathophysiology. Crit Rev Neurobiol 16:1–23

    PubMed  CAS  Google Scholar 

  46. Gonzalez-Burgos G, Lewis DA (2008) GABA neurons and the mechanisms of network oscillations: implications for understanding cortical dysfunction in schizophrenia. Schizophr Bull 34:944–961

    Article  PubMed  Google Scholar 

  47. Jacob TC, Moss SJ, Jurd R (2008) GABAA receptor trafficking and its role in the dynamic modulation of neuronal inhibition. Nat Rev Neurosci 9:331–343

    Article  PubMed  CAS  Google Scholar 

  48. Yuii K, Suzuki M, Kurachi M (2007) Stress sensitization in schizophrenia. Ann N Y Acad Sci 1113:276–290

    Article  PubMed  CAS  Google Scholar 

  49. Collip D, Myin-Germeys I, Van Os J (2008) Does the concept of “sensitization” provide a plausible mechanism for the putative link between the environment and schizophrenia? Schizophr Bull 34:220–225

    Article  PubMed  Google Scholar 

  50. Phillips TJ, Roberts AJ, Lessov CN (1997) Behavioral sensitization to ethanol: genetics and the effects of stress. Pharmacol Biochem Behav 57:487–493

    Article  PubMed  CAS  Google Scholar 

  51. Post RM, Weiss SRB (1996) A speculative model of affective illness cyclicity based on patterns of drug tolerance observed in amygdala-kindled seizures. Mol Neurobiol 13:33–60

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The study was supported by the grant GACR P407/12/1957, project MSM0021620849 provided by Czech Ministry of education and the project “CEITEC – Central European Institute of Technology” (CZ.1.05/1.1.00/02.0068) from European Regional Development Fund.

Author information

Authors and Affiliations

  1. Department of Psychiatry, 1st Faculty of Medicine, Center for Neuropsychiatric Research of Traumatic Stress, Charles University, Prague, Czech Republic

    Petr Bob Ph.D.

Authors
  1. Petr Bob Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Petr Bob Ph.D. .

Editor information

Editors and Affiliations

  1. Sha'ar Menashe Mental Health Center, Hadera, 38814, Israel

    Michael S. Ritsner

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Bob, P. (2013). Stress Sensitization and Anticonvulsant Medication in Psychiatric Patients. In: Ritsner, M. (eds) Polypharmacy in Psychiatry Practice, Volume I. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5805-6_10

Download citation

Publish with us

Policies and ethics

Search

Navigation