Psychiatric comorbidity and use of psychotropic drugs in epilepsy patients

Although epilepsy is associated with a high rate of psychiatric comorbidity, clinicians may withhold treatment with psychotropic drugs for fear of worsening seizures. We have assessed the occurrence of psychiatric disorders in a cohort of epilepsy patients and used the results to discuss this important topic.

Based on a questionnaire we made a survey of psychiatric symptoms in 167 adult patients referred to a tertial epilepsy center. The mean age was 42 years, and 72% had active epilepsy.

Forty three patients (26%) had a psychiatric disorder, and 22 patients (13%) used psychotropic drugs. The most frequent diagnoses were mood disorders and anxiety.

Compared with the general population, people with epilepsy have an increased risk of developing psychiatric disorders. Patients with uncontrolled seizures are most vulnerable. These disorders appear to be under-diagnosed and under-treated, and the fear that psychotropic drugs can cause seizure exacerbation is probably overstated.