Treatment of depressive disorders in epilepsy patients

Epilepsy is a complex disorder that is associated with multiple adverse psychosocial effects. Depression appears to be the most prevalent psychiatric condition in epilepsy and has the greatest impact on subjective health status. Advances in neuroimaging indicate that depressive symptoms are predominantly associated with brain dysfunction, as opposed to social or vocational disability. These findings underscore the need to routinely screen persons with epilepsy for depression, using simple but accurate instruments, and to select the best treatment for each patient, based on adequate understanding of the available pharmacological and interpersonal therapies. This paper reviews epidemiological, health impact, screening and diagnosis, and treatment considerations in depressive disorders associated with epilepsy.