Chapter

Neurobiology of Depression as a Comorbidity of Epilepsy

Raman Sankar and Andrey Mazarati

in Jasper's Basic Mechanisms of the Epilepsies

Fourth edition

Published on behalf of ©Jeffrey L. Noebels, Massimo Avoli, Michael A. Rogawski, Richard W. Olsen, and Antonio V. Delgado-Escueta

Published in print July 2012 | ISBN: 9780199746545
Published online April 2013 | e-ISBN: 9780199322817 | DOI: http://dx.doi.org/10.1093/med/9780199746545.003.0074

Series: Contemporary Neurology Series

Neurobiology of Depression as a Comorbidity of Epilepsy

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In his review on melancholia, Lewis describes Hippocrates as having had the perception that the condition was reciprocally connected to epilepsy.1 Recent epidemiological studies have supported the notion that depression is more frequent among patients with epilepsy (preceding the diagnosis of epilepsy) than among case controls2 and that depression is seven times more likely among adults presenting with a new-onset seizure disorder than among controls.3 Depression has been identified as the most frequent psychiatric comorbidity in patients with epilepsy.4 Hermann et al. have summarized estimates of the prevalence of lifetime-to-date major depression among patients with epilepsy as ranging from 8% to 48%, with a mean and a median approximating 30%.5 Hermann and colleagues also stated that psychiatric comorbidities contributed to a lowered health-related quality of life (HRQOL) in epilepsy.6 Further, their study revealed an association of symptom checklist scores with the chronicity of temporal lobe epilepsy (TLE). Interictal psychiatric symptoms adversely influenced the HRQOL to a greater extent than the frequency, severity, and chronicity of seizures.7 Consideration of the psychiatric comorbidities in treatment decisions involving drug selection have been reviewed for adult8 as well as pediatric9 patients with epilepsy.

Chapter.  6553 words.  Illustrated.

Subjects: Neurology

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