Effects of antiepileptic drugs on mood and behavior

Psychiatric disorders in epilepsy have a multifactorial etiology, pharmacotherapy being only one of many risk factors, which can be both biological and psychosocial. Two important mechanisms of drug-induced psychiatric changes are seizure control/forced normalization in psychosis and GABA-ergic effects in depression. Among the psychiatric adverse events of antiepileptic drugs (AEDs), behavioral problems are the most commonly reported, followed by affective disorders. Psychosis is a relatively rare, although severe, complication. Psychotropic effects of AEDs warrant further research because many relevant parameters related to pathological mechanisms, frequency, psychopathology, and prognosis are not well understood. Behavioral side-effect profiles of AEDs, both negative and positive psychotropic effects, should be considered in the choice of the optimal drug for an individual patient.