Basic treatment principles for psychotic disorders in patients with epilepsy

Area of Science:

• Neurology
• Psychiatry
• Clinical Medicine

Background:

• Psychosis, including interictal (IIP) and postictal (PIP), significantly impacts epilepsy patients' psychosocial well-being.
• Established evidence-based treatment guidelines for psychosis in epilepsy are lacking.
• Non-psychiatrist epileptologists frequently manage these complex cases.

Purpose of the Study:

• To propose practical, evidence-based treatment procedures for IIP and PIP.
• To guide non-psychiatrist epileptologists in managing psychosis in epilepsy patients.
• To emphasize early diagnosis and staging of psychosis.

Main Methods:

• Review of current data and international consensus statements.
• Focus on diagnostic criteria and staging of psychosis.
• Outline of treatment protocols for IIP and PIP.

Main Results:

• Accurate diagnosis and staging are foundational for effective management.
• Treatment for IIP involves patient consent, antiepileptic drug optimization, and antipsychotic pharmacotherapy.
• PIP treatment includes acute protective measures and preventive strategies, emphasizing seizure control.

Conclusions:

• Concise treatment protocols for IIP and PIP can be developed from existing data.
• Early recognition of psychosis in epilepsy is critical.
• Integrated management involving epileptologists and psychiatric care is essential for optimal patient outcomes.