Evidence in support of using a neurochemistry approach to identify therapy for both epilepsy and associated depression

- Altered neurochemistry was estimated in cortex and hippocampus of naïve, kindled and valproate treated kindled animals.
- Altered tryptophan metabolism, dysregulated HPA axis may be considered as culprits for depression association in epilepsy.
- IDO inhibitors as adjuvant therapy may be explored for comprehensive management of epilepsy and comorbid depression.
- Selective serotonergic modulation may also be explored for comprehensive management of epilepsy and comorbid depression.

The present study aimed to develop a neurochemistry-based single or adjuvant therapy approach for comprehensive management of epilepsy and associated depression employing pentylenetetrazole-kindled animals. Kindling was induced in two-month-old male Swiss albino mice by administering a subconvulsant pentylenetetrazole dose (35 mg/kg, i.p.) at an interval of 48 ± 2 h. These kindled animals were treated with saline and sodium valproate (300 mg/kg/day, i.p.) for 15 days. Except for the naïve group, all other groups were challenged with pentylenetetrazole (35 mg/kg, i.p.) on days 5, 10, and 15 to evaluate the seizure severity. Depression was evaluated in all experimental groups after normalization of locomotor activity, using tail suspension and forced swim test on days 1, 5, 10, and 15. Four hours after behavioral evaluations on day 15, all animals were euthanized to collect their serum and discrete brain parts. Corticosterone levels were estimated in all the experimental groups as a marker of a dysregulated hypothalamus pituitary adrenal axis. Neurochemical alterations (norepinephrine, dopamine, tryptophan, kynurenine, serotonin, glutamate, GABA, and total nitrate levels) were also estimated in the cortical and hippocampal areas of the mouse brain. Results revealed that saline-treated kindled animals were associated with significant depression and altered neurochemical milieu in comparison with naïve animals. Chronic valproate treatment in kindled animals significantly reduced seizure severity score bud did not ameliorate associated depression or completely restore altered biochemical and neurochemical milieu. Based on the observation of neurochemical changes in all the groups, we propose that restoration of altered neurochemical milieu, elevated indoleamine 2,3-dioxygenase enzyme activity, and corticosterone levels using pharmacological tools with/out valproic acid may be explored for management of both epilepsy and comorbid depression.

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