Mood and Anxiety Disorders | Psychosis | Nonepileptic Seizures | Psychotropic Medications | Management of Aggressive Behavior and Agitation
There is a substantially elevated prevalence of psychiatric
disorders in epilepsy. The more than fourfold risk of a psychiatric
disorder among people with epilepsy indicated by an analysis of
two decades of Danish national health statistics provides an estimate
of the substantial size of this effect (Christensen et al. 2007). Among psychiatric comorbidities in epilepsy, depression
is the most common, with reported estimates of prevalence commonly
in the range of 20%–50%. Depression is
a stronger determinant of quality of life than seizure control,
but despite its clinical importance it is underdiagnosed and undertreated.
Depression in epilepsy is related to stressors such as disability,
memory problems, being denied a driver's license, stigmatization,
and perceived loss of control. Biological effects are also likely
involved, as indicated by a substantial body of preclinical and
clinical evidence for altered serotonergic transmission in epilepsy
(Alper et al. 2007).