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Related Concept Videos

Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

296
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
296
Antiepileptic Drugs: Glutamate Antagonists01:14

Antiepileptic Drugs: Glutamate Antagonists

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Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
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Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein01:20

Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein

461
Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
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Antiepileptic Drugs: GABAergic Pathway Potentiators01:18

Antiepileptic Drugs: GABAergic Pathway Potentiators

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γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
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Psychosis: Goals of Pharmacotherapy01:26

Psychosis: Goals of Pharmacotherapy

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Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
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Electroconvulsive Therapy01:30

Electroconvulsive Therapy

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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Updated: Sep 19, 2025

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Treating Neuropsychiatric Conditions in Pediatric Epilepsy: Practical Considerations.

D Dilara Ertenu1, Jay A Salpekar1,2

  • 1Neuropsychiatry Program, Kennedy Krieger Institute, Baltimore, MD, USA.

Epilepsy Currents
|June 19, 2025
PubMed
Summary

This review offers guidance for starting epilepsy medications in youth with co-occurring depression, behavioral issues, or attention-deficit/hyperactivity disorder (ADHD). It aids clinicians in optimizing both neurological and psychiatric care for better patient outcomes.

Keywords:
attention-deficit/hyperactivity disorder (ADHD)comorbiditydepressionepilepsyneuropsychiatryoutburstspediatricspsychiatrypsychopharmacologytreatment

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Area of Science:

  • Pediatric Neurology
  • Child Psychiatry
  • Clinical Pharmacology

Background:

  • Epilepsy frequently co-occurs with neuropsychiatric conditions in children and adolescents.
  • Managing these comorbidities presents significant clinical challenges.
  • Existing guidelines often lack specific recommendations for pharmacologic initiation in this complex population.

Purpose of the Study:

  • To present a practical, evidence-informed framework for initiating pharmacologic treatment in pediatric epilepsy patients with comorbid neuropsychiatric symptoms.
  • To guide clinicians in medication selection, initiation, and monitoring.
  • To optimize both neurological and psychiatric outcomes in this patient group.

Main Methods:

  • This is a review article synthesizing current evidence and clinical best practices.
  • The approach focuses on decision-making criteria for medication necessity.
  • Key considerations for psychotropic and antiepileptic drug selection and management are discussed.

Main Results:

  • The review outlines specific criteria for determining when pharmacologic intervention is warranted.
  • It provides guidance on selecting appropriate medications, considering potential interactions and side effects.
  • General principles for safe and effective medication initiation and ongoing monitoring are detailed.

Conclusions:

  • A structured, evidence-based approach is crucial for managing epilepsy with comorbid neuropsychiatric symptoms in youth.
  • Optimizing pharmacologic treatment requires careful consideration of both neurological and psychiatric aspects.
  • The proposed framework aims to improve clinical decision-making and enhance patient outcomes.