Pharmacological treatment of psychiatric comorbidity in patients with refractory epilepsy

Epilepsy Behav. 2013 Oct;29(1):77-81. doi: 10.1016/j.yebeh.2013.06.031. Epub 2013 Aug 9.

Abstract

The purpose of the present study was to describe the use of psychopharmacological drugs for the treatment of a stated or presumed psychiatric comorbid condition in patients with refractory epilepsy and discuss the clinical implications of such treatment. The study was a retrospective descriptive study in patients admitted to the National Center for Epilepsy in Norway based on medication described in medical records. The mean age was 40 years (range: 9-90), and the gender ratio was 56/44% female/male. Psychotropic drugs (antidepressants and antipsychotics) were used to a lower extent than in the general population in Norway. Drugs for ADHD were predominantly used in children. The prevalence of patients treated with psychiatric comedication was 13% (143 of 1139 patients). The patients used two to eight concomitant CNS-active drugs, which calls for the close monitoring of potential pharmacodynamic and pharmacokinetic interactions and should challenge clinicians to achieve a less complex pharmacotherapy. Psychiatric comorbidity is an important concern in patients with refractory epilepsy and may be undertreated.

Keywords: Antiepileptic drugs; Epilepsy; Psychiatric comorbidity; Psychotropic drugs.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anticonvulsants / therapeutic use
  • Attention Deficit Disorder with Hyperactivity / drug therapy
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Child
  • Drug Therapy, Combination / methods
  • Drug Therapy, Combination / statistics & numerical data
  • Epilepsy / drug therapy
  • Epilepsy / epidemiology*
  • Female
  • Humans
  • Male
  • Mental Disorders / drug therapy*
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Norway / epidemiology
  • Prevalence
  • Psychiatric Status Rating Scales
  • Psychotropic Drugs / therapeutic use*
  • Young Adult

Substances

  • Anticonvulsants
  • Psychotropic Drugs