Depression in Persons With Epilepsy: Lessons From Case Review.
Autor: | Abell K; From the Department of Psychiatry and Behavioral Health, George Washington University School of Medicine and Health Sciences, Washington, DC., Sit DK; Asher Center for the Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL., Wisner KL; Developing Brain Institute, Children's National Hospital, Washington, DC. |
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Jazyk: | angličtina |
Zdroj: | Journal of clinical psychopharmacology [J Clin Psychopharmacol] 2024 May-Jun 01; Vol. 44 (3), pp. 272-277. |
DOI: | 10.1097/JCP.0000000000001848 |
Abstrakt: | Background: Major depressive disorder is highly prevalent among persons with epilepsy (PWEs). Between 30% and 50% of PWEs suffer from depression. Many factors contribute to this prevalence, including the psychosocial impact of the diagnosis, restrictions on driving and certain types of work, and adverse effects associated with antiseizure medications. Without proper treatment, depressed PWEs have increased risks for suicide, strained relationships, lowered seizure control, and impairment in functioning. Our objective was to use the existing literature and insights from our experience in treating depression and anxiety in PWEs within an academic mood disorders center. We aimed to provide practical guidance for health care professionals who treat depression in this population. Methods: Persons with epilepsy and depression were identified by their treating psychiatrists. Their electronic health records were reviewed and compiled for this report, with a total of 12 included in this review. Records were reviewed regarding antiseizure medications, psychotropic medications, light therapy, psychotherapy, other interventions, and treatment response. Results: Based on our review of literature, as well as review of cases of individuals with epilepsy and comorbid psychiatric conditions, we recommend a step-wise evidence-based approach of optimizing psychiatric medication doses, augmenting with additional medication and/or implementing nonpharmacological interventions such as light therapy and psychotherapy. Conclusions: In PWEs, improvement in depression, other psychiatric symptoms, and function are the goals of drug and nondrug interventions. Depression care has the potential to significantly improve the quality of life of PWEs and reduce both morbidity and mortality. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
Databáze: | MEDLINE |
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