Actualización sobre la comorbilidad migraña-depresión

Introducción: La migraña y el trastorno depresivo son patologías altamente prevalentes e incapacitantes, las cuales presentan relaciones bidireccionales de comorbilidad. En la literatura se han descrito factores de riesgo y mecanismos fisiopatológicos comunes para ambas enfermedades, así como asociaciones entre estas y su presentación clínica. Métodos: El presente texto es una revisión narrativa de la literatura. La búsqueda del material bibliográfico se hizo mediante distintas bases de datos especializadas en el área de la salud. Resultados: Algunos factores de riesgo están asociados con ambas patologías, y ambas comparten factores patogénicos, incluidos cambios funcionales, estructurales, genéticos, epigenéticos y hormonales, entre otros. Varios de los tratamientos preventivos que han demostrado eficacia en el tratamiento de la migraña son medicamentos o medidas con efecto antidepresivo. Discusión: Si se consideran las asociaciones y los factores comunes descritos en la literatura, se hace evidente que en el enfoque de pacientes diagnosticados con alguna de estas patologías es necesario tener en cuenta una posible comorbilidad entre migraña y depresión. Conclusión: Es importante promover el tamizaje de estas dos condiciones en pacientes diagnosticados con alguna de ellas, pues esto puede tener implicaciones terapéuticas e impacto en la calidad de vida.

Introduction: Migraine and depressive disorder are highly prevalent and disabling pathologies, which present bidirectional relationships of comorbidity. Common risk factors and pathophysiological mechanisms for both diseases have been described in the literature, as well as associations between them and their clinical presentation. Methods: This text is a narrative literature review. The bibliographical material was found through different databases specialized in health sciences. Results: Some risk factors are associated with both pathologies, and both share pathogenic factors, including functional, structural, genetic, epigenetic, hormonal changes, among others. Several of the preventive treatments that have shown efficacy in the treatment of migraine are medications or measures with an antidepressant effect. Discussion: Considering the associations and common factors described in the literature, it becomes evident that in the approach to patients diagnosed with any of these pathologies, it may be beneficial to consider a possible migraine-depression comorbidity. Conclusion: It is important to promote the screening of these two patients diagnosed with some, since it can have therapeutic implications and impact on quality of life.

Avoidant restrictive eating disorder and panic attacks in an adult man: A case report / Trastorno evitativo restrictivo de la ingesta alimentaria y ataques de pánico en un hombre adulto: Reporte de caso

Abstract Avoidant or Restrictive Food Intake Disorder (ARFID) is an eating disorder (ED) not common in adults. In this article we present a clinical case of ARFID in a 37-year-old male patient treated in an ED center in Medellin, Colombia; displaying anxious symptoms that began a year earlier and concomitant weight loss, following a traumatic event causing an overall impairment with that patient. Several medical evaluations/examinations looking for organic causes, were excluded. Interventions were implemented by a psychiatry, a psychotherapist using cognitive-behavior therapy (CBT), and a nutritionist, all in face-to-face modality, which were carried out weekly for the first three months, then biweekly and subsequently quarterly. each lasting approximately 40-60 minutes. After the set of pharmacological interventions and psychotherapy, a great improvement in the functionality of the patient was observed. Improvement was found with respect to eating in public, food variation and panic attacks. In the absence of guidelines, it is important to use standardized and replicable treatments in this population.

Resumen El trastorno evitativo restrictivo de la ingesta (TERIA) es un trastorno alimentario (TCA) raro en adultos. Se presenta el caso de un hombre de 37 años con TERIA y trastorno de pánico atendido en un centro para TCA en Medellín, Colombia, quien presentó un año de síntomas ansiosos y pérdida de peso después de evento traumático, generando disfuncionalidad. Fue evaluada y excluida organicidad. Se realizaron intervenciones por parte de psiquiatría, psicoterapia con enfoque cognitivo conductual y nutrición, todas en modalidad presencial, las cuales se realizaron semanalmente los primeros tres meses, luego quincenalmente y posteriormente trimestralmente. Cada una con una duración de 40-60 minutos aproximadamente por sesión. Posterior al conjunto de intervenciones farmacológicas y psicoterapia, se observó una gran mejoría la funcionalidad del paciente, se encontró mejoría con respecto a comer en público, variación en los alimentos y ataques de panico. Ante la ausencia de guías de manejo de TERIA en adultos es relevante realizar tratamientos estandarizados que puedan ser replicados.

Confirmación de la presencia de células serotoninérgicas en la corteza cerebral fetal en cultivos e in situ / Confirmation of the presence of serotonergic cells in the fetal cerebral cortex in cultures and in situ

Resumen Antecedentes: La aparición temprana de serotonina en el cerebro fetal y sus efectos en la morfogénesis cerebral apoyan su papel neurotrófico. Objetivo: Determinar la presencia de células serotoninérgicas y la expresión de triptófano-5-hidroxilasa (TPH), 5-hidroxitriptamina (5-HT), transportador de serotonina (SERT), receptor 5-HT1A y Pet-1 durante el desarrollo de la corteza cerebral, tanto in situ como en cultivo de tejidos. Material y métodos: Se realizó estudio observacional descriptivo en ratas Wistar preñadas. La presencia del tapón se consideró el inicio de la gestación; en los días 13, 16 y 17 se practicaron cesáreas para obtener los fetos e inmediatamente se disecaron los cerebros para identificar células serotoninérgicas, TPH, 5-HT, SERT, 5-HT1A y Pet-1 en cultivo de tejido e in situ mediante inmunomarcaje detectado en un microscopio confocal. Resultados: Células y terminales serotoninérgicas fueron observadas en el mesencéfalo el día 17 de gestación y en cocultivos de neopalio los días 13 y 16. También se observaron células inmunopositivas a TPH, 5-HT, SERT y Pet-1 en el neopalio en el día 12 del cultivo. Conclusiones: Se confirmó la presencia de células serotoninérgicas y otros elementos del sistema serotoninérgico en la corteza cerebral temprana, la cual puede ser transitoria y participar en los procesos de maduración cortical durante el desarrollo cerebral.

Abstract Background: Early appearance of serotonin in the fetal brain and its effects on brain morphogenesis support its neurotrophic role. Objective: To determine the presence of serotonergic cells and the expression of tryptophan-5-hydroxylase (TPH), 5-hydroxytryptamine (5-HT), serotonin transporter (SERT), 5-HT1A receptor and Pet-1 during the development of the cerebral cortex, both in situ and in tissue cultures. Material and methods: A descriptive, observational study was carried out in pregnant Wistar rats. The presence of the plug was regarded as the beginning of gestation. On days 13, 16 and 17, cesarean sections were performed to obtain the fetuses, and the brains were then immediately dissected to identify the presence of serotonergic cells, TPH, 5-HT, SERT, 5-HT1A and Pet-1 in tissue cultures and in situ by immunostaining detected on a confocal microscope. Results: Serotonergic cells and terminals were observed in the midbrain on day 17 of gestation, and in neopallium cocultures on days 13 and 16. TPH, 5-HT, SERT and Pet-1 immunopositive cells were also observed in the neopallium on day 12 of culture. Conclusions: The presence of serotonergic cells and other elements of the serotonergic system in the early cerebral cortex was confirmed, which may be transient and participate in cortical maturation processes during brain development.

The Efficacy of Different Triptans for the Treatment of Acute Headache in Pediatric Migraine: A Systematic Review

Background: Serotonin receptors 5-HT1B and 5-HT1D in the cerebral arteries are activated by the 5-hydroxytryptophan agonists (triptans) to relieve the discomfort associated with migraines. Even though triptans are often used to treat acute migraines, there is some debate over their effectiveness. Objective: Our systematic review aimed to evaluate the effectiveness of triptans for acute treatment of migraine in young individuals. Methods: Utilizing the databases of Google Scholar, Cochrane Library, and PubMed, a literature search was conducted, and all papers published till July 2022 were included. This systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. In addition to the Boolean operators AND, OR, and NOT, the following descriptive terms were also used: “Triptans,” “Pediatric Migraine,” “Migraine disorders,” “Headache,” “Children,” and “Adolescent.” Results: A total of 1047 studies were identified, and 25 articles were finally included in the study. 17 of them were RCTs while the remaining were non-randomized trials. Most studies recruited participants aged between 12-17 years. Among 25 studies, 7 reported sumatriptan use, 3 assessed a combination of sumatriptan and naproxen, 4 were on almotriptan, 1 on eletriptan, 6 on rizatriptan, and 4 on zolmitriptan use. Conclusion: We found that rizatriptan (good tolerability profile with a dose of 5 mg) and sumatriptan (nasal spray, 10 mg and 20 mg) had higher efficiency as compared to other triptans. Regardless of type or dose, all triptans are generally well tolerated by patients, but a few adverse effects such as light-headedness (sumatriptan), nasopharyngitis, and, muscular spasms (sumatriptan/ naproxen), somnolence, and dry mouth (rizatriptan), and dizziness (zolmitriptan group) were reported with the triptans.

Efectos de los Polimorfismos del Transportador y de los Receptores de Serotonina en la Depresión

Introducción: La serotonina tiene gran implicación en la regulación del estado emocional y la ejecución de tareas cognitivas, de modo que los genes del transportador de serotonina (5-HTT, SLC6A4) y de los receptores de serotonina (HTR1A, HTR1B, HTR2A) se convierten en candidatos adecuados para estudiar los efectos de estos genes y sus variaciones polimórficas en las características de la depresión. Objetivo: Revisión de reportes de investigación que hayan estudiado los efectos de las variantes de los genes del transportador y de los receptores de serotonina en las diferentes características clínicas de la depresión. Métodos: Se realizó una búsqueda en las bases de datos Scopus, Web of Science y PubMed con las palabras clave "depression", AND "polymorphism". Conclusiones: Según la revisión de 54 artículos, se encontró que el alelo corto del polimorfismo de 5-HTTLPR es el factor de riesgo más reportado en relación con el desarrollo de depresión y su gravedad. Las variantes de los genes estudiados (SLC6A4, HTR1A, HTR1B y HTR2A) pueden generar alteraciones morfológicas de estructuras cerebrales.

Introduction: Serotonin is highly implicated in the regulation of emotional state and the execution of cognitive tasks, so much so that the serotonin transporter genes (5-HTT, SLC6A4) and the serotonin receptor genes (HTR1A, HTR1B, HTR2A) have become the perfect candidates when studying the effects that these genes and their polymorphic variations have on depression characteristics. Objective: A review of research reports that have studied the effects of variations in the serotonin transporter and receptor genes on different clinical features of depression. Methods: A search of the Scopus, Web of Science and PubMed databases was conducted using the keywords ("depression" AND "polymorphism"). Conclusions: According to the review of 54 articles, the short allele of the 5-HTTLPR polymorphism was found to be the most reported risk factor related to the development of depression and its severity. Variations in the genes studied (SLC6A4, HTR1A, HTR2A) can generate morphological alterations of brain structures.

Serotonin, ghrelin, and motilin gene/receptor/transporter polymorphisms in childhood functional constipation

SUMMARY OBJECTIVE: Functional constipation is the most common form of constipation, and its exact aetiology is still unclear. However, it is known that deficiencies in hormonal factors cause constipation by changing physiological mechanisms. Motilin, ghrelin, serotonin acetylcholine, nitric oxide, and vasoactive intestinal polypeptide are factors that play a role in colon motility. There are a limited number of studies in the literature where hormone levels and gene polymorphisms of serotonin and motilin are examined. Our study aimed to investigate the role of motilin, ghrelin, and serotonin gene/receptor/transporter polymorphisms in constipation pathogenesis in patients diagnosed with functional constipation according to the Rome 4 criteria. METHODS: Sociodemographic data, symptom duration, accompanying findings, the presence of constipation in the family, Rome 4 criteria, and clinical findings according to Bristol scale of 200 cases (100 constipated patients and 100 healthy control) who applied to Istanbul Haseki Training and Research Hospital, Pediatric Gastroenterology Outpatient Clinic, between March and September 2019 (6-month period) were recorded. Polymorphisms of motilin-MLN (rs2281820), serotonin receptor-HTR3A (rs1062613), serotonin transporter-5-HTT (rs1042173), ghrelin-GHRL (rs27647), and ghrelin receptor-GHSR (rs572169) were detected by real-time PCR. RESULTS: There was no difference between the two groups in terms of sociodemographic characteristics. Notably, 40% of the constipated group had a family history of constipation. The number of patients who started to have constipation under 24 months was 78, and the number of patients who started to have constipation after 24 months was 22. There was no significant difference between constipation and control groups in terms of genotype and allele frequencies in MLN, HTR3A, 5-HTT, GHRL, and GHSR polymorphisms (p<0.05). Considering only the constipated group, the rates of gene polymorphism were similar among those with/without a positive family history of constipation, constipation onset age, those with/without fissures, those with/without skin tag, and those with type 1/type 2 stool types according to the Bristol stool scale. CONCLUSION: Our study results showed that gene polymorphisms of these three hormones may not be related to constipation in children.

Effects of tricyclic antidepressants, selective serotonin reuptake inhibitors, and selective serotonin-norepinephrine reuptake inhibitors on the ocular surface / Efeitos dos antidepressivos tricíclicos, inibidores seletivos da recaptação da serotonina e inibidores da recaptação de serotonina e noradrenalina na superfície ocular

ABSTRACT Purpose: This study aimed to investigate the effects of tricyclic antidepressants, selective serotonin reuptake inhibitors, and selective serotonin noradrenaline reuptake inhibitors on the ocular surface. Methods: The study included 330 eyes of 165 patients using antidepressants and 202 eyes of 101 controls. Tear fluid breakup time, Schirmer I test, and Ocular Surface Disease Index (OSDI) questionnaire were administered. Beck Depression Inventory and Beck Anxiety Inventory were applied to record drug use, dosages, psychiatric disease duration, and remission time. Results: Mean tear fluid breakup time was 14.29 ± 4.81 (4-26) sec, and Schirmer I test value was 16.05 ± 5.89 (2-28) mm in study group. Tear fluid breakup time was 18.16 ± 2.12 (15-24) sec and Schirmer I test value was 16.64 ± 2.31 (15-24) mm in control group (p<0.001 and p=0.005, respectively). In study group, 38.18% (n=63) of patients had dry eye, and 17% (n=18) of patients in control group had dry eye (p<0.001). The mean OSDI score was 82.56 ± 16.21 (66-100) in the tricyclic antidepressants Group, 60.02 ± 29.18 (10-100) in the serotonin reuptake inhibitors Group, and 22.30 ± 20.87 (0-75) in the serotonin-noradrenaline reuptake inhibitors Group (p<0.001). Mean tear fluid breakup time was 14.36 ± 3.35 (10-20) sec in tricyclic antidepressants Group, 13.94 ± 5.81 (4-26) sec in the serotonin reuptake inhibitors Group, and 14.93 ± 4.20 (6-20) sec in serotonin-noradrenaline reuptake inhibitors Group (p=0.730). The mean Schirmer I test value was 9.90 ± 7.22 (2-30) mm in tricyclic antidepressants Group, 15.55 ± 5.15 (2-25) mm in serotonin reuptake inhibitors Group and 17.71 ± 4.21 (10-30) mm in serotonin-noradrenaline reuptake inhibitors Group (p<0.001). There was no statistically significant difference between OSDI score, tear fluid breakup time, and Schirmer I test values in serotonin reuptake inhibitors and serotonin-no­radrenaline reuptake inhibitors subgroups. Conclusions: Dry eye is common in antidepressant users, but considering the ocular surface, serotonin-noradrenaline reuptake inhibitors may be more reliable than other antidepressants. Patients using serotonin-noradrenaline reuptake inhibitors have lower OSDI scores. Serotonin-noradrenaline reuptake inhibitors, which are useful in chronic pain syndromes, may also have a corrective effect on dry eye symptoms.

RESUMO Objetivo: O objetivo deste estudo é investigar os efeitos dos antidepressivos tricíclicos, dos inibidores da recaptação da serotonina e dos inibidores da recaptação da serotonina e noradrenalina na superfície ocular. Métodos: Foram incluídos no estudo 330 olhos de 165 pacientes em uso de antidepressivos e 202 olhos de 101 controles. Foi medido o tempo de ruptura do fluido lacrimal e foram administrados o teste de Schirmer I e o questionário Ocular Surface Disease Index (OSDI). Os Inventários de Depressão e de Ansiedade de Beck foram aplicados ao uso dos medicamentos e foram registrados as dosagens, a duração da doença psiquiátrica e o tempo de remissão. Resultados: No grupo de estudo, o tempo médio de ruptura do fluido lacrimal foi de 14,29 ± 4,81 segundos (intervalo de 4-26 segundos) e o valor médio do teste de Schirmer I foi de 16,05 ± 5,89 mm (intervalo de 2-28 mm). No grupo controle. o tempo médio de rompimento do fluido lacrimal foi de 18,16 ± 2,12 segundos (intervalo de 15-24 segundos) e o valor do teste de Schirmer I foi de 16,64 ± 2,31 mm (intervalo de 15-24 mm), com p<0,001 e p=0,005, respectivamente. No grupo de estudo, 38,18% (n=63) dos pacientes tinham olho seco, enquanto no grupo controle 17% (n=18) tinham olho seco (p<0,001). O escore médio no OSDI foi de 82,56 ± 16,21 (intervalo 66-100) no grupo dos antidepressivos tricíclicos, 60,02 ± 29,18 (10-100) no grupo dos inibidores da recaptação da serotonina e 22,30 ± 20,87 (0-75) no grupo dos inibidores da recaptação da serotonina e noradrenalina (p<0,001). O tempo médio de rompimento do fluido lacrimal foi de 14,36 ± 3,35 segundos (intervalo de 10-20 segundos) no grupo dos antidepressivos tricíclicos, 13,94 ± 5,81 segundos (intervalo de 4-26 segundos) no grupo dos inibidores da recaptação de serotonina e 14,93 ± 4,20 segundos (intervalo de 6-20 segundos) no grupo dos inibidores da recaptação de serotonina e noradrenalina (p=0,730). O valor médio do teste de Schirmer I foi de 9,90 ± 7,22 mm (intervalo de 2-30 mm) no grupo dos antidepressivos tricíclicos, 15,55 ± 5,15 mm (intervalo de 2-25 mm) no grupo dos inibidores da recaptação da serotonina e 17,71 ± 4,21 mm (intervalo de 10-30 mm) no grupo dos inibidores da recaptação da serotonina e noradrenalina (p<0,001). Não houve diferença estatisticamente significativa no escore OSDI, no tempo de ruptura do fluido lacrimal e nos valores do teste de Schirmer I entre os subgrupos de pacientes em uso de inibidores da recaptação de serotonina e de inibidores da recaptação de serotonina e noradrenalina. Conclusões: Olho seco é uma queixa comum em usuários de antidepressivos, mas no que diz respeito à superfície ocular, inibidores da recaptação de serotonina e noradrenalina podem ser mais confiáveis que outros antidepressivos. Pacientes em uso de inibidores da recaptação de serotonina e noradrenalina têm escores menores no questionário OSDI. Os inibidores da recaptação da serotonina e noradrenalina, úteis nas síndromes de dor crônica, também podem ter um efeito corretivo nos sintomas de olho seco.

Hemodynamic course during ablation and selective hepatic artery embolization for metastatic liver carcinoid: a retrospective observational study

Abstract Background: Manipulation of carcinoid tumors during ablation or selective hepatic artery embolization (transarterial embolization, TAE) can release vasoactive mediators inducing hemodynamic instability. The main aim of our study was to review hemodynamics and complications related to minimally invasive treatments of liver carcinoids with TAE or ablation. Methods: Electronic medical records of all patients with metastatic liver carcinoid undergoing ablation or TAE from 2003 to 2019 were abstracted. Noted were severe hypotension (mean arterial pressure [MAP] ≤ 55 mmHg), severe hypertension (systolic blood pressure ≥ 180 mmHg), and perioperative complications. Associations of procedure type and pre-procedure octreotide use with intraprocedural hemodynamics were assessed using linear regression. A robust covariance approach using generalized estimating equation method was used to account for multiple observations. Results: A total of 161 patients underwent 98 ablations and 207 TAEs. Severe hypertension was observed in 24 (24.5%) vs. 15 (7.3%), severe hypotension in 56 (57.1%) vs. 6 (2.9%), and cutaneous flushing observed in 2 (2.0%) vs. 48 (23.2%) ablations and TAEs, respectively. After adjusting for preprocedural MAP, ablation was associated with lower intraprocedural MAP compared to TAE (estimate −27 mmHg, 95%CI −30 to −24 mmHg, p < 0.001). Intraprocedural declines in MAP were not affected by preprocedural use of octreotide (p = 0.7 for TAE and p = 0.4 for ablation). Conclusions: Ablation of liver carcinoids was associated with substantial hemodynamic instability, especially hypotension. In contrast, a higher number of TAE patients had cutaneous flushing. Preprocedural use of octreotide was not associated with attenuation of intraprocedural hypotension.

Gastroesophageal tube of the Iguana iguana (Iguanidae): histological description, histochemical and immunohistochemical analysis of 5-HT and SS cells / Tubo gastroesofágico da Iguana iguana (Iguanidae): descrição histológica, histoquímica e análise imunohistoquímica de células 5-HT e SS

Abstract The work aims were to describe the histological and histochemical structure of the gastroesophageal tube of Iguana iguana and verify the occurrence and distribution of immunoreactive serotonin (5-HT) and somatostatin (SS) cells. Fragments of the gastrointestinal tract (GIT) of five iguanas were which underwent standard histological and immunohistochemistry technique. Immunoreactive cells for 5-HT and SS were quantified using the STEPanizer. The oesophagus has ciliated columnar pseudostratified epithelium with staining Alcian blue (AB) + and goblet cells highly reactive to periodic acid Schiff (PAS). In the cervical oesophagus, the numerical density of 5-HT cells per unit area (QA [5-HT cells]/µm2) was 4.6x10-2 ± 2.0 and celomatic oesophagus presented QA = 4.0x10-2 ± 1.0. The epithelium of the stomach is simple columnar, PAS and AB +. The cranial and middle regions of the stomach presented (QA [5-HT cells]/µm2) = 6.18x10-2 ± 3.2 and the caudal region, QA = 0.6x10-2 ± 0.2. The SS cells were only observed in the caudal stomach, with numerical density (QA [SS cells]/µm2) = 1.4x10-2 ± 0.9 In I. iguana, variation was observed in terms of the distribution of mucus secretions and the pattern of occurrence of serotonin and somatostatin-secreting enteroendocrine cells in the TGI, which possibly will result in an interspecific adaptive response.

Resumo Os objetivos do trabalho foram descrever a estrutura histológica e histoquímica do tubo gastroesofágico da Iguana iguana e verificar a ocorrência e distribuição de células serotonina (5-HT) e somatostatina (SS) imunorreativas. Fragmentos do trato gastrointestinal (TGI) de cinco iguanas foram submetidos à técnica histológica e imunohistoquímica padrão. As células imunorreativas para 5-HT e SS foram quantificadas usando o STEPanizer. O esôfago apresenta epitélio pseudoestratificado colunar ciliado Alcian blue (AB) positivo, com células caliciformes altamente reativas ao ácido periódico de Schiff (PAS). No esôfago cervical, a densidade numérica de células 5-HT por unidade de área (QA [células 5-HT] / µm2) foi de 4.6x10-2 ± 2.0 e o esôfago celomático apresentou QA = 4.0x10-2 ± 1.0. O epitélio do estômago é colunar simples, PAS e AB positivo. As regiões cranial e média do estômago apresentaram (QA [células 5-HT] / µm2) = 6.18x10-2 ± 3.2 e a região caudal, QA = 0.6x10-2 ± 0.2. As células SS foram observadas apenas no estômago caudal, com densidade numérica (QA [células SS] / µm2) = 1.4x10-2 ± 0.9. Em I. iguana, foi observada variações em termos da distribuição das secreções de muco e padrão de ocorrência das células enteroendócrinas secretoras de serotonina e somatostatina no TGI, o que possivelmente reflete uma resposta adaptativa interespecifica.

Efficacy and safety of phosphodiesterase type 5 inhibitors and selective serotonin reuptake inhibitors in the treatment of comorbiditiy of erectile dysfunction and premature ejaculation: a meta analysis / 现代泌尿外科杂志

【Objective】 To evaluate the efficacy and safety of phosphodiesterase type 5 (PDE5) inhibitors alone or in combination with selective serotonin reuptake inhibitors (SSRIs) compared with SSRIs alone in the treatment of comorbidity of erectile dysfunction (ED) and premature ejaculation (PE). 【Methods】 The clinical randomized controlled trials of ED and PE comorbidity treated with PDE5 inhibitors alone or in combination with SSRIs were searched from database inception to Sep.2022, in CNKI, PubMed, Web of Science, Embase, Wanfang Database, cqVIP Database, SinoMed and Yiigle. The intravaginal ejaculatory latency time(IELT), score of International Index of Erectile Function 5 (IIEF-5) and adverse reaction rate were analyzed with RevMan 5.4.1 software. 【Results】 A total of9 studies involving 793 patients were included. Meta analysis showed that compared with SSRIs alone, PDE5 inhibitors alone or in combination with SSRIs yielded better results in IELT [MD=1.99, 95%CI(1.51-2.46), P<0.001] and higher IIEF-5 score [MD=4.61, 95%CI(3.68-5.55), P<0.001] , but no increase in adverse events [RR=0.99, 95%CI(0.74-1.31), P=0.92] . 【Conclusion】 In the treatment of ED and PE comorbidity, priority should be given to ED or both ED and PE, which can produce better efficacy without increasing the adverse effects.

Effect and mechanism of serotonin-selective reuptake inhibitor on bone metabolism / 中国药房

Serotonin-selective reuptake inhibitor （SSRI） is the first-line drug for treating depression. SSRI mainly include fluoxetine， paroxetine， sertraline， fluvoxamine， citalopram and escitalopram， etc. SSRI has dual impact on bone metabolism. Short- term use of SSRI may have a positive impact on bone， but long-term use may lead to bone problems. This article summarizes the effects and mechanisms of SSRI on bone metabolism， indicating that SSRI can affect bone formation， bone resorption， mesenchymal stem cell differentiation， and regulate the expression of inflammatory cytokines. The impact of SSRI on bone metabolism can be achieved by affecting classical signaling pathways such as cAMP/PKA/CREB， Wnt/β-catenin， BMP/Smad， OPG/RANKL/RANK， and through centrally mediated effects.

Syndrome Differentiation-based Treatment of Diarrhea-predominant Irritable Bowel Syndrome with Chinese Medicine via 5-HT Signaling Pathway： A Review / 中国实验方剂学杂志

Diarrhea-predominant irritable bowel syndrome （IBS-D） is a chronic functional bowel disorder characterized by abdominal pain and diarrhea， with visceral hypersensitivity and abnormal gastrointestinal dynamics as the pathophysiological basis. The brain-gut interaction plays a role in pain-related functional gastrointestinal disorders， especially IBS-D. 5-Hydroxytryptamine （5-HT）， as an important brain-gut peptide regulating gastrointestinal function， affects brain activity， gastrointestinal motility， pain perception， mucosal inflammation， and immune response through brain-gut interaction and is associated with the occurrence and development of IBS-D. In recent years， traditional Chinese medicine （TCM） has shown great potential to mitigate gastrointestinal symptoms and improve the quality of life with its holistic view and treatment based on syndrome differentiation. Studies have shown that TCM treats IBS-D by regulating the 5-HT signaling pathway. With a focus on syndrome differentiation in TCM， this paper systematically describes the efficacy and mechanism of TCM in treating different TCM syndromes of IBS-D via the 5-HT signaling pathway， aiming to provide a scientific basis for TCM treatment of this disease.

Gastroesophageal tube of the Iguana iguana (Iguanidae): histological description, histochemical and immunohistochemical analysis of 5-HT and SS cells / Tubo gastroesofágico da Iguana iguana (Iguanidae): descrição histológica, histoquímica e análise imunohistoquímica de células 5-HT e SS

The work aims were to describe the histological and histochemical structure of the gastroesophageal tube of Iguana iguana and verify the occurrence and distribution of immunoreactive serotonin (5-HT) and somatostatin (SS) cells. Fragments of the gastrointestinal tract (GIT) of five iguanas were which underwent standard histological and immunohistochemistry technique. Immunoreactive cells for 5-HT and SS were quantified using the STEPanizer. The oesophagus has ciliated columnar pseudostratified epithelium with staining Alcian blue (AB) + and goblet cells highly reactive to periodic acid Schiff (PAS). In the cervical oesophagus, the numerical density of 5-HT cells per unit area (QA [5-HT cells]/µm2) was 4.6x10-2 ± 2.0 and celomatic oesophagus presented QA = 4.0x10-2 ± 1.0. The epithelium of the stomach is simple columnar, PAS and AB +. The cranial and middle regions of the stomach presented (QA [5-HT cells]/µm2) = 6.18x10-2 ± 3.2 and the caudal region, QA = 0.6x10-2 ± 0.2. The SS cells were only observed in the caudal stomach, with numerical density (QA [SS cells]/µm2) = 1.4x10-2 ± 0.9 In I. iguana, variation was observed in terms of the distribution of mucus secretions and the pattern of occurrence of serotonin and somatostatin-secreting enteroendocrine cells in the TGI, which possibly will result in an interspecific adaptive response.

Os objetivos do trabalho foram descrever a estrutura histológica e histoquímica do tubo gastroesofágico da Iguana iguana e verificar a ocorrência e distribuição de células serotonina (5-HT) e somatostatina (SS) imunorreativas. Fragmentos do trato gastrointestinal (TGI) de cinco iguanas foram submetidos à técnica histológica e imunohistoquímica padrão. As células imunorreativas para 5-HT e SS foram quantificadas usando o STEPanizer. O esôfago apresenta epitélio pseudoestratificado colunar ciliado Alcian blue (AB) positivo, com células caliciformes altamente reativas ao ácido periódico de Schiff (PAS). No esôfago cervical, a densidade numérica de células 5-HT por unidade de área (QA [células 5-HT] / µm2) foi de 4.6x10-2 ± 2.0 e o esôfago celomático apresentou QA = 4.0x10-2 ± 1.0. O epitélio do estômago é colunar simples, PAS e AB positivo. As regiões cranial e média do estômago apresentaram (QA [células 5-HT] / µm2) = 6.18x10-2 ± 3.2 e a região caudal, QA = 0.6x10-2 ± 0.2. As células SS foram observadas apenas no estômago caudal, com densidade numérica (QA [células SS] / µm2) = 1.4x10-2 ± 0.9. Em I. iguana, foi observada variações em termos da distribuição das secreções de muco e padrão de ocorrência das células enteroendócrinas secretoras de serotonina e somatostatina no TGI, o que possivelmente reflete uma resposta adaptativa interespecifica.

Gastroesophageal tube of the Iguana iguana (Iguanidae): histological description, histochemical and immunohistochemical analysis of 5-HT and SS cells

Abstract The work aims were to describe the histological and histochemical structure of the gastroesophageal tube of Iguana iguana and verify the occurrence and distribution of immunoreactive serotonin (5-HT) and somatostatin (SS) cells. Fragments of the gastrointestinal tract (GIT) of five iguanas were which underwent standard histological and immunohistochemistry technique. Immunoreactive cells for 5-HT and SS were quantified using the STEPanizer. The oesophagus has ciliated columnar pseudostratified epithelium with staining Alcian blue (AB) + and goblet cells highly reactive to periodic acid Schiff (PAS). In the cervical oesophagus, the numerical density of 5-HT cells per unit area (QA [5-HT cells]/µm2) was 4.6x10-2 ± 2.0 and celomatic oesophagus presented QA = 4.0x10-2 ± 1.0. The epithelium of the stomach is simple columnar, PAS and AB +. The cranial and middle regions of the stomach presented (QA [5-HT cells]/µm2) = 6.18x10-2 ± 3.2 and the caudal region, QA = 0.6x10-2 ± 0.2. The SS cells were only observed in the caudal stomach, with numerical density (QA [SS cells]/µm2) = 1.4x10-2 ± 0.9 In I. iguana, variation was observed in terms of the distribution of mucus secretions and the pattern of occurrence of serotonin and somatostatin-secreting enteroendocrine cells in the TGI, which possibly will result in an interspecific adaptive response.

Resumo Os objetivos do trabalho foram descrever a estrutura histológica e histoquímica do tubo gastroesofágico da Iguana iguana e verificar a ocorrência e distribuição de células serotonina (5-HT) e somatostatina (SS) imunorreativas. Fragmentos do trato gastrointestinal (TGI) de cinco iguanas foram submetidos à técnica histológica e imunohistoquímica padrão. As células imunorreativas para 5-HT e SS foram quantificadas usando o STEPanizer. O esôfago apresenta epitélio pseudoestratificado colunar ciliado Alcian blue (AB) positivo, com células caliciformes altamente reativas ao ácido periódico de Schiff (PAS). No esôfago cervical, a densidade numérica de células 5-HT por unidade de área (QA [células 5-HT] / µm2) foi de 4.6x10-2 ± 2.0 e o esôfago celomático apresentou QA = 4.0x10-2 ± 1.0. O epitélio do estômago é colunar simples, PAS e AB positivo. As regiões cranial e média do estômago apresentaram (QA [células 5-HT] / µm2) = 6.18x10-2 ± 3.2 e a região caudal, QA = 0.6x10-2 ± 0.2. As células SS foram observadas apenas no estômago caudal, com densidade numérica (QA [células SS] / µm2) = 1.4x10-2 ± 0.9. Em I. iguana, foi observada variações em termos da distribuição das secreções de muco e padrão de ocorrência das células enteroendócrinas secretoras de serotonina e somatostatina no TGI, o que possivelmente reflete uma resposta adaptativa interespecifica.

Avaliação da qualidade do sono e níveis séricos de serotonina e cortisol em pacientes com dor crônica / Evaluation of sleep quality and serum levels of serotonin and cortisol in patients with chronic pain / Evaluación de la calidad del sueño y de los niveles séricos de serotonina y cortisol en pacientes con dolor crónico

A dor crônica pode acometer indivíduos de qualquer idade e está atribuída a maior morbidade, declínio cognitivo e imobilidade. Nos pacientes com dor crônica, ocorrem alterações importantes na neurotransmissão, além de alterações endócrinas relacionadas ao estresse. Além do mais, a má qualidade do sono leva a alterações cognitivas, irritabilidade e fadiga durante o dia e está, comumente, presente em pacientes com dor crônica. Assim, o presente estudo avaliou, por meio da aplicação de questionários a indivíduos adultos com diagnóstico de dor crônica, atendidos em ambulatório de reumatologia da microrregião de Alfenas-MG, a qualidade de vida, o padrão da dor e a qualidade do sono, além da análise da dosagem sérica de serotonina e cortisol. Dos 57 pacientes que fizeram parte da amostra, a maioria era composta por mulheres (91,2%), com idade maior de 40 anos (87,7%). Os principais diagnósticos envolvidos foram fibromialgia (35%), osteoartrite (21%) e artrite reumatoide (14%). Os resultados obtidos apontaram moderada intensidade da dor e interferência das atividades diárias, regular estado de saúde geral e má qualidade do sono nestes indivíduos. De acordo com os dados, não houve correlação estatisticamente relevante entre a severidade da dor e a qualidade de sono, tampouco entre a severidade da dor e o estado de saúde geral. Por outro lado, houve correlação positiva moderada entre a severidade da dor e a interferência nas atividades diárias, e correlação negativa moderada entre a severidade da dor e a saúde mental do indivíduo. Também ficou claro que a interferência da dor nas atividades diárias impacta negativamente na saúde mental. Não foi possível constatar uma relação entre a má qualidade do sono e maior intensidade da dor, mas sim entre qualidade de sono e saúde mental, impactando significativamente também no estado geral de saúde. A qualidade do sono impacta ainda na relação das atividades do cotidiano e influencia negativamente a saúde mental. Por fim, no presente estudo não foi evidenciada correlação significativa entre o diagnóstico de dor crônica e alterações de níveis séricos de serotonina e cortisol. Em conclusão, os achados demonstram a complexidade do tratamento de pacientes com dor crônica. Considerando que a dor crônica desencadeia um amplo espectro de alterações orgânicas e cognitivas, torna-se essencial compreender como essas alterações se associam, para que sejam desenvolvidas abordagens preventivas e terapêuticas mais efetivas.

Chronic pain can affect individuals of any age and is associated with increased morbidity, cognitive decline, and immobility. In patients with chronic pain, there are important changes in neurotransmission, in addition to stress-related endocrine changes. Moreover, poor sleep quality leads to cognitive changes, irritability, and fatigue during the day and is commonly present in patients with chronic pain. Thus, the present study evaluated, by means of applying questionnaires to adult individuals diagnosed with chronic pain, seen at a rheumatology outpatient clinic in the Alfenas-MG microregion, the quality of life, the pattern of pain and the quality of sleep, in addition to the analysis of serum serotonin and cortisol levels. Of the 57 patients who were part of the sample, most were women (91.2%), aged over 40 years (87.7%). The main diagnoses involved were fibromyalgia (35%), osteoarthritis (21%), and rheumatoid arthritis (14%). The results obtained indicated moderate pain intensity and interference with daily activities, regular general health status, and poor sleep quality in these individuals. According to the data, there was no statistically relevant correlation between pain severity and sleep quality, nor between pain severity and general health status. On the other hand, there was a moderate positive correlation between pain severity and interference with daily activities, and a moderate negative correlation between pain severity and the individual's mental health. It was also clear that pain interference with daily activities negatively impacts mental health. A relationship between poor sleep quality and greater pain intensity could not be found, but rather between sleep quality and mental health, impacting significantly on overall health status as well. Sleep quality also impacts the relationship of activities of daily living and negatively influences mental health. Finally, in the present study no significant correlation was evidenced between the diagnosis of chronic pain and changes in serum levels of serotonin and cortisol. In conclusion, the findings demonstrate the complexity of treating patients with chronic pain. Considering that chronic pain triggers a broad spectrum of organic and cognitive changes, it becomes essential to understand how these changes associate so that more effective preventive and therapeutic approaches can be developed.

dolor crónico puede afectar a individuos de cualquier edad y se asocia a una mayor morbilidad, deterioro cognitivo e inmovilidad. En los pacientes con dolor crónico se producen importantes alteraciones en la neurotransmisión, además de cambios endocrinos relacionados con el estrés. Además, un sueño de mala calidad conduce a alteraciones cognitivas, irritabilidad y fatiga durante el día, y está comúnmente presente en pacientes con dolor crónico. Así, el presente estudio evaluó, mediante la aplicación de cuestionarios a individuos adultos diagnosticados de dolor crónico, atendidos en una consulta externa de reumatología de la microrregión de Alfenas-MG, la calidad de vida, el patrón de dolor y la calidad del sueño, además del análisis del dosaje sérico de serotonina y cortisol. De los 57 pacientes que formaron parte de la muestra, la mayoría eran mujeres (91,2%), mayores de 40 años (87,7%). Los principales diagnósticos fueron fibromialgia (35%), artrosis (21%) y artritis reumatoide (14%). Los resultados obtenidos señalaron una intensidad moderada del dolor y una interferencia de las actividades cotidianas, un estado de salud general regular y una mala calidad del sueño en estas personas. Según los datos, no existía una correlación estadísticamente relevante entre la intensidad del dolor y la calidad del sueño, ni entre la intensidad del dolor y el estado general de salud. Por otro lado, existía una correlación positiva moderada entre la intensidad del dolor y la interferencia en las actividades cotidianas, y una correlación negativa moderada entre la intensidad del dolor y la salud mental del individuo. También quedó claro que la interferencia del dolor en las actividades cotidianas repercute negativamente en la salud mental. No fue posible encontrar una relación entre una mala calidad del sueño y una mayor intensidad del dolor, sino más bien entre la calidad del sueño y la salud mental, lo que también repercute significativamente en el estado general de salud. La calidad del sueño también repercute en la relación de las actividades diarias e influye negativamente en la salud mental. Por último, en el presente estudio no se evidenció una correlación significativa entre el diagnóstico de dolor crónico y las alteraciones en los niveles séricos de serotonina y cortisol. En conclusión, los hallazgos demuestran la complejidad del tratamiento de los pacientes con dolor crónico. Teniendo en cuenta que el dolor crónico desencadena un amplio espectro de alteraciones orgánicas y cognitivas, se hace imprescindible comprender cómo se asocian estas alteraciones, para poder desarrollar abordajes preventivos y terapéuticos más eficaces.

Validation and clinical application of the Metacognitions Questionnaire in a sample of Brazilian generalized anxiety disorder patients: the effects of different treatment interventions

Abstract Introduction Metacognitive beliefs about worry may trigger anxiety. However, the effect of generalized anxiety disorder (GAD) treatment on metacognition has not yet been investigated. Objectives To validate the Metacognitions Questionnaire (MCQ-30) in a Brazilian GAD sample and verify whether different interventions reduce metacognitive beliefs. Method We recruited 180 GAD individuals and randomized them to Body in Mind Training (BMT), Fluoxetine (FLX), or an active control group (Quality of Life [QoL]) for 8 weeks. The MCQ-30 was assessed for internal consistency, was evaluated with confirmatory and exploratory factor analyses, and was tested for convergent validity with the Penn State Worry Questionnaire (PSWQ). Generalized estimating equations (GEE) were employed to analyze differences after the interventions. Results The MCQ-30 demonstrated good internal consistency and acceptability; the original five-factor model was supported. There was a positive moderate correlation between MCQ-30 scores and worry. GEE showed a significant group x time interaction (p < 0.001). Both BMT (mean difference [MD] = -6.04, standard error [SE] = -2.39, p = 0.034) and FLX (MD = -5.78, SE = 1.91, p = 0.007) reduced MCQ-30 scores. FLX was superior to QoL, but not BMT, at weeks 5 and 8. There were no differences between BMT and QoL. Conclusion The Brazilian-Portuguese version of MCQ-30 showed good psychometric properties. Furthermore, the positive effect of FLX and BMT on metacognition suggests it may represent a potential therapeutic target.

La miocardiopatía hipertrófica induce cambios en la expresión de la triptófano-5-hidroxilasa, el transportador de serotonina y receptores serotoninérgicos / Hypertrophic cardiomyopathy induces changes in the tryptophan-5-hydroxylase, serotonin transporter and serotonergic receptors expressions

Resumen Introducción: Los cardiomiocitos poseen la maquinaria bioquímica capaz de sintetizar, utilizar y recapturar serotonina. Objetivo: Determinar si la miocardiopatía hipertrófica (MCH) induce cambios en la expresión de la triptófano-5-hidroxilasa (TPH) 1 y 2, el transportador de serotonina (SERT) y los receptores serotoninérgicos (RS). Métodos: Estudio transversal de cinco bloques de tejido de corazones con MCH y cinco bloques de corazones de control. Se obtuvieron cinco cortes de la pared libre del ventrículo izquierdo (PLVI) y del septum interventricular (SIV) de cada bloque, para determinar la expresión de TPH1 y TPH2, SERT y RS con anticuerpos por inmunofluorescencia. La inmunofluorescencia fue evaluada mediante t de WELCH, con nivel de significación de p < 0.05. Resultados: La PLVI y el SIV de los corazones con MCH mostraron aumento de la expresión de TPH1 y TPH2, así como de los receptores 5-HT2A y 5-HT2B en comparación con los controles (p < 0.01). El receptor 5-HT4 y SERT aumentaron en el SIV de los corazones con MCH (p < 0.01). Conclusiones: Se demostró aumento de las expresiones de TPH, SERT y RS en los cardiomiocitos de los corazones con MCH en comparación con los controles, lo cual podría participar en la fisiopatología de la MCH en los humanos.

Abstract Introduction: Cardiomyocytes have a biochemical machinery with the capacity to synthesize, utilize and reuptake serotonin. Objective: To determine whether hypertrophic cardiomyopathy (HCM) induces changes in the expression of tryptophan-5-hydroxylase (TPH) 1 and 2, serotonin transporter (SERT) and serotonergic receptors (SR). Methods: Cross-sectional study of five tissue blocks from hearts with HCM and five controls. Five sections of the left ventricular free wall (LVFW) and interventricular septum (IVS) were obtained from each block to determine the expression of TPH1 and TPH2, SERT and SRs by immunofluorescence with specific antibodies. Immunofluorescence was evaluated by WELCH t-test, with a level of significance of p < 0.05. Results: LVFW and IVS of hearts with HCM showed an increase in the expression of TPH1 and TPH 2 and 5-HT2A and 5-HT2B receptors in comparison with controls (p < 0.01). The 5-HT4 receptor and SERT showed an increase in the IVS of hearts with HCM (p < 0.01). Conclusions: This study demonstrated an increased expression of TPH, SERT and SRs in cardiomyocytes from hearts with HCM in comparison with controls, which could be involved in the pathophysiology of HCM in humans.

Total serum cholesterol level in patients with major depressive disorder: Simple yet undermined

Human brain cholesterol acts as structural components of cellular membrane, synapse and dendrite formation.Researchers have found a possible association between low serum cholesterol levels and mood disorders though the literature from India in this regard is limited. To estimate serum levels of total cholesterol in patients with major depressive disorder. 75 patients of MDD were compared with equal number of age and sex matched controls. 5 ml of fasting sample of blood was obtained in a plain vacutainer to analyse total cholesterol level by Cholesterol oxidase-peroxidase method. Statistical analysis: The obtained results were tabulated and analyzed by multiple logistic regression analysis, independent t-test, Chi-square test and area under the curve. The mean level of cholesterol in cases (158.85±61.22 mg/dL) which was significantly lower compared to the controls (182.71±40.98 mg/dL) with P <0.01. The symptoms of MDD negatively correlated with lower serum cholesterol level with odds ratio of 0.99. There was statistically significant lower level of cholesterol in the MDD group below 140 mg/dL compared to the control group with P <0.001. As the measurement of total serum cholesterol is simple and cost effective, it can be used as an important biochemical marker for MDD.

Cambios en la actividad y expresión de las triptófano-5-hidroxilasas cerebrales y en el número de neuronas serotoninérgicas por la diabetes mellitus, que no retornan a la normalidad con la insulina / Diabetes mellitus causes changes in brain tryptophan-5-hydroxylases activity and expression and in the number of serotonergic neurons, which do not return to normal with insulin treatment

Resumen Introducción: La diabetes mellitus (DM) inhibe la biosíntesis de serotonina cerebral mediante cambios en la actividad y expresión de triptófano-5-hidroxilasa (TPH). Objetivos: Determinar si los cambios en la expresión de TPH1 y TPH2 cerebral y en el número de neuronas serotoninérgicas causados por la DM retornan a la normalidad en ratas con diabetes tratadas con insulina. Métodos: Ratas con diabetes inducida con estreptozotocina se dividieron en dos grupos uno tratado con insulina y otro sin tratamiento. En el día 14, se obtuvieron tallos cerebrales para cuantificar niveles de L-triptófano, 5-hidroxitriptamina y la actividad de la TPH. La expresión de TPH1 y TPH2 fue mediante Western blot y el número de neuronas serotoninérgicas por inmunohistoquímica. Resultados: En las ratas con diabetes se confirmó disminución de los niveles de L-triptófano, 5-hidroxitriptamina y la actividad de la TPH, así como menor expresión de TPH1 y TPH2 y menor número de neuronas serotoninérgicas. Cuando las ratas diabéticas fueron tratadas con insulina, el L-triptófano regresó a la normalidad, no así la 5-hidroxitriptamina, la expresión de TPH ni el número de neuronas serotoninérgicas. Conclusiones: La DM inhibe crónicamente la síntesis de 5-hidroxitriptamina cerebral mediante modificaciones en la expresión de TPH1 y TPH2 y disminución de las neuronas serotoninérgicas, que persisten a pesar del tratamiento con insulina.

Abstract Introduction: Diabetes mellitus (DM) inhibits brain serotonin biosynthesis through changes in tryptophan-5-hydroxylase (TPH) activity and expression. Objectives: To determine whether DM-induced changes in brain TPH1 and TPH2 expression and in the number of serotonergic neurons return to normal in diabetic rats treated with insulin. Methods: Rats with streptozotocin-induced diabetes were divided in two groups: one treated with insulin and the other without treatment. On day 14, brain stems were obtained in order to quantify L-tryptophan and 5-hydroxytryptamine levels, as well as to determine TPH activity. The expressión of TPH1 and THP2 by Western blot, and the number of serotonergic neurons by immunohistochemistry. Results: In diabetic rats, a decrease in the levels of L-tryptophan, 5-hydroxytryptamine and TPH activity was confirmed, as well as lower TPH1 and TPH2 expression and lower numbers of serotonergic neurons. When diabetic rats were treated with insulin, L-tryptophan returned to normal, but not 5-hydroxytryptamine, TPH expression, or the number of serotonergic neurons. Conclusions: DM chronically inhibits the synthesis of brain 5-hydroxytryptamine through changes in TPH1 and TPH2 expression and a decrease in the number of serotonergic neurons, which persist despite insulin treatment.

Role of Gabanergic and, or Serotonergic in the Anti-seizure Activity of Methanol Extract of Crinum jagus (J. Thomps) in Experimental Mice

Objective: Crinum jagus is used in traditional African medicine in the treatment of epilepsy, pain and inflammations. Methods: Anticonvulsant activity was investigated using picrotoxin (PCT) and strychnine (STR) tests in experimental paradigm. Results: Crinum jagus leaf methanol extract (200, 400, and 800?mg?kg?1) potentiated hexobarbitone-induced sleeping time and significantly (p<0.05) shortened the duration of convulsions in PCT-induced seizures. Delay in the onset of convulsions in PCT-induced seizure were very significant (p<0.05). Reduction in the frequency of seizures was also significant (p<0.05) in the test. Diazepam (5?mg?kg?1) was used as reference anticonvulsant drugs in the experimental models. While, CJB failed to protect the animals against picrotocin-induced convulsion. Neither the extract of CJL nor CJB confer significant effect on STR-induced convulsion. Flumazenil (GABA receptor antagonist) and cyproheptadine (5-HT2 receptor antagonist) blocked the effect of CJL extract in the PCT tests significantly suggesting that Crinum jagus may be acting by enhancing the effects of the GABAergic and serotonergic systems. Conclusion: The data obtained suggest that methanol leaf extract of C. jagus possessed significant anticonvulsant effect, thereby confirming the traditional uses of C. jagus in the treatment of epilepsies; mechanisms of which may involve interaction with GABAergic and serotonergic pathway.