Naked Science Forum

Life Sciences => Physiology & Medicine => Topic started by: paul.fr on 14/07/2007 09:21:38

Title: epilepsy and psychiatric symptoms.
Post by: paul.fr on 14/07/2007 09:21:38

Can this be due to the medication, rather than the epilepsy itself? I just wonder because, if i think back this is when my memory really started to be effected and the start of my constant overthinking. as discussed in this topic http://www.thenakedscientists.com/forum/index.php?topic=8777.msg104578#msg104578

if it helps, the drug i was on was called Carbamazepine, and i think i was on 1000mg per day.

a few quotes from the show:

Quote

Another thing that I’m particularly interested in the relationship between epilepsy and psychiatric symptoms, although the two might seem to be rather different. First of all they both involve the same organ, that is the brain. Sometimes what happens is if you have a discharge in one part of the brain that can actually generate a range of psychiatric symptoms. These might be to do with depression, you might sometimes, rarely, but sometimes quite dramatically, get symptoms of what we call psychosis. Seeing things that aren’t there, hearing voices…

Quote

Howard - Well this is where it gets extremely interesting. The brain, as you know, does all sorts of interesting things, pretty much it does everything we are and everything we do. Epilepsy is a manifestation of increased activity in those brain cells and therefore all the things that we can do, essentially, can be generated by seisures. But because it’s an abnormal way of activating these nerve cells we get things broken up, we don’t get the whole pattern of behaviour. So people have had intense religious experiences, there are accounts of a feeling of conviction, an absolutely free-floating certainty. “This is right!” Which just exists by itself, which is rather unusual.

Howard - That’s absolutely right and in principle it should be very straightforward; you map where the epileptic focus is, that is the site of the seisure, with the behaviour and you know exactly what’s going on. It’s not as simple as that for several reasons. First of all, because it turns out that there are several different parts of the brain that can generate individual emotional psychiatric symptoms. Secondly it’s very hard sometimes, particularly if you don’t have deep electrodes, wires in the brain recording exactly where the seisure is starting, to be sure exactly where the seisure is starting. Nerve cells are of course, a microscopic thing, and we’re looking at chunks of brain millimetres or bigger.

Title: epilepsy and psychiatric symptoms.
Post by: iko on 15/07/2007 21:11:47

Hi paul.fr,

I may be boring and repetitive, but I keep thinking that occult infections are being re-evaluated these days as a major cause of diseases of uncertain etiology.
May be only in a restricted number of patients, still this is very interesting and quite exciting!
Toxoplasma is one of the highly suspected 'invisible enemies' and perhaps my favourite one.
Epilepsy and Toxoplasma give 34 citations on PubMed today.
Starting from 1969...so it's not a new thing, but something suspected and then left there for lack of 'evidence'.  It happened many times in medical research.

I post the most recent, and this deals with "meta-analysis", today's gold standard in clinical medicine to put together good evidence from separated studies:

Meta-analysis of three case controlled studies and an ecological study
into the link between cryptogenic epilepsy and chronic toxoplasmosis infection.

---

Palmer BS.
Barts & The London, Queen Mary's School of Medicine & Dentistry, University of London, United Kingdom.

A meta-analysis was performed on three case controlled studies which examined the relationship between latent toxoplasmosis gondii infection in the immunocompetent host and cryptogenic epilepsy. Further comparison was also made by examining the seroprevalence of toxoplasmosis rates for 17 various countries, cities or regions against the prevalence rates for epilepsy in those regions.
RESULTS: The results for the meta-analysis showed a log-odds ratio of 4.8 which approximates to a similar relative risk, (CI 2.6 to 7.8), with CI for all three studies being above 1. Seroprevalence rates for toxoplasmosis and prevalence rates of epilepsy showed a strong association (p<0.001).
DISCUSSION: The prevalence of toxoplasmosis is an important factor in the prevalence of epilepsy with a probable link in the cryptogenic epilepsies. An area with a reduced burden of toxoplasmosis will also have a reduced burden of epilepsy. Neuropathophysiology findings from various studies show a common physical relationship of microglial nodule formation in Toxoplasma gondii infection and epilepsy. This analysis raises the possibility that one of the many causes of epilepsy may be an infectious agent, or that cryptogenic epilepsy may be a consequence of latent toxoplasmosis infection. This raises the possibility that public health measures to reduce toxoplasmosis infection may also result in a reduction in epilepsy.

Seizure. 2007 Jun 27; [Epub ahead of print]

---

Of course this cannot be the only cause of epilepsy, but offers new hints of investigation and may be a promise for practical applications in a short time.
We discussed some of these issues in a special topic right here:

http://www.thenakedscientists.com/forum/index.php?topic=6657.0

...over 2000 viewers since last Feb. is not so bad.

ikod    [^]

Title: epilepsy and psychiatric symptoms.
Post by: paul.fr on 16/07/2007 09:37:37

Many thanks, Enrico. i will check the other topic out.

Title: epilepsy and psychiatric symptoms.
Post by: RD on 16/07/2007 16:48:09

Carbamazepine (Tegretol) damps down electrical activity: its main side-effect is sedation.
 So "overthinking" , increased mental activity, is not consistent with a side-effect of Tegretol.

Apparently you have changed your anti-convulsant Paul. You should not suddenly stop taking
 anti-convulsants, as a backlash effect could occur causing unprecidentedly severe symptoms.

If you are stopping taking anticonvulsants they should be tapered off slowly under medical supervision.

Title: epilepsy and psychiatric symptoms.
Post by: paul.fr on 16/07/2007 17:35:50

Quote from: RD on 16/07/2007 16:48:09

Carbamazepine (Tegretol) damps down electrical activity: its main side-effect is sedation.
 So "overthinking" , increased mental activity, is not consistent with a side-effect of Tegretol.

Apparently you have changed your anti-convulsant Paul. You should not suddenly stop taking
 anti-convulsants, as a backlash effect could occur causing unprecidentedly severe symptoms.

If you are stopping taking anticonvulsants they should be tapered off slowly under medical supervision.

I stopped taking the Carbamazepine, about 18 years ago. When i told the specialist at the hospital, his responce was that he then doubted that i had epilepsy in the first place. There was no follow up checks or anything. I did stop taking them at once, no weaning or tapering off. As i previously mentioned,  this is when my memory started to be effected and the start of my constant overthinking. Although it has only gor teally bad in the last 6 or 7 years.

Title: epilepsy and psychiatric symptoms.
Post by: another_someone on 16/07/2007 20:33:44

Quote from: paul.fr on 16/07/2007 17:35:50

I stopped taking the Carbamazepine, about 18 years ago. When i told the specialist at the hospital, his responce was that he then doubted that i had epilepsy in the first place. There was no follow up checks or anything. I did stop taking them at once, no weaning or tapering off. As i previously mentioned,  this is when my memory started to be effected and the start of my constant overthinking. Although it has only gor teally bad in the last 6 or 7 years.

I assume that you are suggesting that the effects are not of the drug, but of a rebound from the drug.

Title: epilepsy and psychiatric symptoms.
Post by: paul.fr on 16/07/2007 22:08:30

Quote from: another_someone on 16/07/2007 20:33:44

I assume that you are suggesting that the effects are not of the drug, but of a rebound from the drug.

Not really a suggestion, more of a curiosity. I went from being unable to think (pretty much sedated at all times) for a year to a slow steady rise in overthinking (after stopping the medication). ending up in the state i am now.

Today, has been a total nightmare. i tried for 3 hours to get to sleep but just laid there "thinking", i tried all the usual things to calm it down but nothing was working, in the end only exhaustion let me fall asleep and that was not for too long.

Title: epilepsy and psychiatric symptoms.
Post by: RD on 17/07/2007 16:44:33

1000mg (1gram) carbamazepine daily is a moderately high dose which could cause sedation.
A lower dose of 400 - 600mg daily can be used to treat disorders such as hypomania.

http://en.wikipedia.org/wiki/Hypomania

Carbamazepine is now available in a slow release formula,
giving a more even delivery of the drug througout the day.

(No I don't have shares in the company who makes it  [:)])

Title: epilepsy and psychiatric symptoms.
Post by: iko on 17/07/2007 17:39:34

...and could carbamazepine affect 'occult pathogen' behaviour?
it's still a mystery to me!  [;D]
Pure speculation my friends.

Quote from: iko on 02/03/2007 22:38:17

And what about this?
That's reeeally neat!
Me like this stuff:

Drugs used in the treatment of schizophrenia and bipolar disorder
 inhibit the replication of Toxoplasma gondii.

---

Jones-Brando L, Torrey EF, Yolken R.
Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Blalock 1149, Baltimore, MD 21287-4933, USA. lbrando@jhmi.edu

The exact mechanisms of action of some antipsychotics and mood stabilizers have not been elucidated. Response to these medications can vary among individuals. Recent studies indicate that infection with the parasite Toxoplasma gondii may contribute to the symptoms of schizophrenia in some individuals.
We investigated commonly used antipsychotic and mood stabilizing medications for their ability to inhibit the replication of this organism.We employed a system for testing compounds for in vitro activity against T. gondii. Human fibroblasts (HFF) were treated with test compounds and then exposed to Toxoplasma that has been genetically modified to express cytoplasmic beta-galactosidase. Inhibition by the drugs was determined by spectrophotometric analysis of colorimetric reactions.We tested 12 neuroleptic compounds and found that of these, the antipsychotic haloperidol and the mood stabilizer valproic acid most effectively inhibit Toxoplasma growth in vitro. Valproic acid inhibited the parasite at a concentration below that found in the cerebrospinal fluid and blood of individuals being treated with this medication and displayed synergistic activity with haloperidol and with trimethoprim, an antibiotic commonly used to treat Toxoplasma infections.Several medications used to treat schizophrenia and bipolar disorder have the ability to inhibit the in vitro replication of T. gondii.

Schizophr Res. 2003 Aug 1;62(3):237-44.

---

Now, just for fun, could vitamin D3
from cod liver oil help alleviating
a chronic Toxoplasma infection?
As usual, the 'evidence' is weak...
but towards a positive effect.
wow

1,25(OH)2D3 inhibits in vitro and in vivo intracellular growth of apicomplexan parasite Toxoplasma gondii.

---

Rajapakse R, Uring-Lambert B, Andarawewa KL, Rajapakse RP, Abou-Bacar A, Marcellin L, Candolfi E.
Institut de Parasitologie et de Pathologie et Tropicale, de la Faculte de Medecine, EA 3950 Interactions Cellulaires et Moleculaires Hote-Parasite, 3 rue Koeberle, 67000 Strasbourg, France.

The hormonal form of vitamin D, 1,25-dyhydroxyvitamin D3 (1,25(OH)2D3), is implicated in a wide range of functions other than its classical role in calcium and phosphorous homeostasis.
When Toxoplasma gondii-infected BALB/c mice were treated with 1,25(OH)2D3, they succumb to death sooner than their counterparts. But they showed less parasite burden in tissues which was further supported by mild pathological lesions. As an effort to understand the physiological mechanism for the above observation an in vitro study was performed. Fewer parasites were observed when 1,25(OH)2D3 pre-treated murine intestinal epithelial cells were challenged with parasites. Moreover, the observed inhibition was dose-dependent and had a maximum effect with 10(-7)M of 1,25(OH)2D3. However, no observable difference was observed, when pre-incubated parasites were added to cells suggesting that the observed inhibition was a result of an effect from 1,25(OH)2D3 on Toxoplasma intracellular growth.
Our data support the notion that 1,25(OH)2D3 may inhibit intra cellular T. gondii parasite proliferation in vivo and in vitro.

J Steroid Biochem Mol Biol. 2007 Jan 30; [Epub ahead of print]

---

I begin to think that, perhaps only in a certain percentage
of psychiatric patients, hidden Toxoplasma infection
could contribute to neurologic symptoms and some people
might benefit from long-term anti-Toxoplasma treatment.

Hidden, chronic, paucisymptomatic* and persistent
infections by common pathogens had been quite
underestimated so far.
(see the Helicobacter story in "New cancer theory")
But this is a new century...

* Che?...sorry, I learned
English from a book!
from: Manuel  BBC - Fawlty Towers
(https://www.thenakedscientists.com/forum/proxy.php?request=http%3A%2F%2Fwww.iptv.org%2Ffriends%2Fbritcom%2Fimages%2FFawltyGasp.jpg&hash=721c8b217d59dfd49cc52d33e1e777b7)
http://www.iptv.org/friends/britcom/images/FawltyGasp.jpg

Title: epilepsy and psychiatric symptoms.
Post by: RD on 19/07/2007 14:38:01

Hi Iko,
Paul reports that his "overthinking" began after stopping Carbamazepine. If this drug were the cause of his psychiatric disorder, (e.g. your suggestion that it enabled toxoplasma to reproduce more rapidly), then his symptoms would have been worse while taking the Carbamazepine.

Title: epilepsy and psychiatric symptoms.
Post by: iko on 19/07/2007 14:54:50

Quote from: RD on 19/07/2007 14:38:01

Hi Iko,
Paul reports that his "overthinking" began after stopping Carbamazepine. If this drug were the cause of his psychiatric disorder, (e.g. your suggestion that it enabled toxoplasma to reproduce more rapidly), then his symptoms would have been worse while taking the Carbamazepine.

Hi RD,

I was obviously speculating about possible effects in general, not referring to Paul's history in particular!
Apart from any speculation, tegretol-carbamazepine should 'slow-down' you brain, and stopping it may cause the opposite effect...but I am not your expert at all!

ikod

Title: epilepsy and psychiatric symptoms.
Post by: ukpcdaz on 10/04/2008 22:39:59

Hi all, Sorry I'm new to this forum, but found this topic through Google, and I'm experiencing exactly the same thing.

I took Carbamazepene from the age of about 5 til about 15, at 1000mg, three times a day.

Since then (and indeed I remember feeling like this as a child, from about 6 or 7 years old), I have been paranoid, anxious, and suffered from 'over-thinking'. I literally assess everything. I can't sleep for thinking. Thoughts race through my head, about all sorts of things, sometimes things that I can't even define, to the point, that when I'm trying to concentrate, I simply can't. My mood is unstable - I am mostly depressed (clinically) but small things can make me highly excitable and almost hyperactive. (It's most a kind of bi-polar.. which I know Carbamazepine is also used as a treatment for..)

I am convinced there is some kind of link, but I've not found much about it, although I found a few papers on in various journals through Sciencedirect.

Title: epilepsy and psychiatric symptoms.
Post by: rosalind dna on 10/04/2008 23:13:04

I took Carbemazepine/Tegretol once and I am so allergic to it
that it nearly killed, I can take it now for the fear of the
memory lose and the other said symptoms that I suffered
including a horrible rash, the increase in my seizures.

But I have heard that for each seizure someone has that a tiny bit of their brain cells dies so does their memory. I  have a good
memory.