Skip to main content
SpringerLink
Log in

Depression

  • Chapter
Neuropsychiatric Symptoms of Epilepsy

Part of the book series: Neuropsychiatric Symptoms of Neurological Disease ((NSND))

Abstract

Depressive disorders are the most frequent psychiatric comorbidity in people with epilepsy, with lifetime prevalence rates of 30–35 %. Their prevalence is also higher than in the general population, and in particular, in people with poorly controlled seizures. In addition, there is a complex relation between epilepsy and depressive disorders, whereby not only are patients with epilepsy at greater risk of developing depressive disorders, but patients with primary depressive disorders are at greater risk of developing epilepsy. In this chapter, we review the salient aspects of depressive disorders in epilepsy that any clinician treating people with epilepsy must know.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tellez-Zenteno JF, Patten SB, Jette N, Williams J, Wiebe S. Psychiatric comorbidity in epilepsy: a population-based analysis. Epilepsia. 2007;48(12):2336–44.

    PubMed  Google Scholar 

  2. Edeh J, Toone B. Relationship between interictal psychopathology and the type of epilepsy. Results of a survey in general practice. Br J Psychiatry. 1987;151:95–101.

    Article  CAS  PubMed  Google Scholar 

  3. Jacoby A, Baker GA, Steen N, Potts P, Chadwick DW. The clinical course of epilepsy and its psychosocial correlates: findings from a U.K. Community study. Epilepsia. 1996;37(2):148–61.

    Article  CAS  PubMed  Google Scholar 

  4. O'Donoghue MF, Goodridge DM, Redhead K, Sander JW, Duncan JS. Assessing the psychosocial consequences of epilepsy: a community-based study. Br J Gen Pract. 1999;49(440):211–4.

    PubMed Central  PubMed  Google Scholar 

  5. Ettinger A, Reed M, Cramer J. Depression and comorbidity in community-based patients with epilepsy or asthma. Neurology. 2004;63(6):1008–14.

    Article  PubMed  Google Scholar 

  6. Caplan R, Siddarth P, Gurbani S, Hanson R, Sankar R, Shields WD. Depression and anxiety disorders in pediatric epilepsy. Epilepsia. 2005;46(5):720–30.

    Article  PubMed  Google Scholar 

  7. Kanner AM, Kozak AM, Frey M. The use of sertraline in patients with epilepsy: is it safe? Epilepsy Behav. 2000;1(2):100–5.

    Article  PubMed  Google Scholar 

  8. Ettinger AB, Weisbrot DM, Nolan EE, Gadow KD, Vitale SA, Andriola MR, et al. Symptoms of depression and anxiety in pediatric epilepsy patients. Epilepsia. 1998;39(6):595–9.

    Article  CAS  PubMed  Google Scholar 

  9. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–71.

    Article  CAS  PubMed  Google Scholar 

  10. Gilliam FG, Barry JJ, Hermann BP, Meador KJ, Vahle V, Kanner AM. Rapid detection of major depression in epilepsy: a multicentre study. Lancet Neurol. 2006;5(5):399–405.

    Article  PubMed  Google Scholar 

  11. Hesdorffer DC, Ishihara L, Mynepalli L, Webb DJ, Weil J, Hauser WA. Epilepsy, suicidality, and psychiatric disorders: a bidirectional association. Ann Neurol. 2012;72:184–91.

    Article  PubMed  Google Scholar 

  12. Adelow C, Anderson T, Ahlbom A, Tomson T. Hospitalization for psychiatric disorders before and after onset of unprovoked seizures/epilepsy. Neurology. 2012;78:396–401.

    Article  PubMed  Google Scholar 

  13. Forsgren L, Nystrom L. An incident case-referent study of epileptic seizures in adults. Epilepsy Res. 1990;6(1):66–81.

    Article  CAS  PubMed  Google Scholar 

  14. Dc H, Hauser WA, Annegers JF, Cascino G. Major depression is a risk factor for seizures in older adults. Ann Neurol. 2000;47(2):246–9.

    Article  Google Scholar 

  15. Hesdorffer DC, Hauser WA, Olafsson E, Ludvigsson P, Kjartansson O. Depression and suicide attempt as risk factors for incident unprovoked seizures. Ann Neurol. 2006;59(1):35–41.

    Article  PubMed  Google Scholar 

  16. Alper K, Schwartz KA, Kolts RL, Khan A. Seizure incidence in psychopharmacological clinical trials: an analysis of Food and Drug Administration (FDA) summary basis of approval reports. Biol Psychiatry. 2007;62(4):345–54.

    Article  PubMed  Google Scholar 

  17. Kanner AM. Depression and epilepsy: how can we explain their bidirectional relation? Epilepsia. 2011;52 Suppl 1:21–7.

    Article  PubMed  Google Scholar 

  18. Specchio LM, Iudice A, Specchio N, La Neve A, Spinelli A, Galli R, et al. Citalopram as treatment of depression in patients with epilepsy. Clin Neuropharmacol. 2004;27(3):133–6.

    Article  CAS  PubMed  Google Scholar 

  19. Favale E, Rubino V, Mainardi P, Lunardi G, Albano C. The anticonvulsant effect of fluoxetine in humans. Neurology. 1995;45:1926.

    Article  CAS  PubMed  Google Scholar 

  20. Favale E, Audenino D, Cocito L, Albano C. The anticonvulsant effect of citalopram as an indirect evidence of serotonergic impairment in human epileptogenesis. Seizure. 2003;12(5):316–8.

    Article  CAS  PubMed  Google Scholar 

  21. Kanner AM. Can neurobiological pathogenic mechanisms of depression facilitate the development of seizure disorders? Lancet Neurol. 2012;11(12):1093–102.

    Article  CAS  PubMed  Google Scholar 

  22. Jobe PC. Affective disorder and epilepsy comorbidity in the genetically epilepsy prone-rat (GEPR). In: Gilliam FG, Kanner AM, Sheline YI, editors. Depression and brain dysfunction. London: Taylor & Francis; 2006. p. 121–57.

    Google Scholar 

  23. Mazarati AM, Siddarth P, Baldwin RA, et al. Depression after status epilepticus: behavioural and biochemical deficits and effects of fluoxetine. Brain. 2008;131:2071–83.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Kumar G, Couper A, O'Brien TJ, Salzberg MR, Jones NC, Rees SM, Morris MJ. The acceleration of amygdala kindling epileptogenesis by chronic low-dose corticosterone involves both mineralocorticoid and glucocorticoid receptors. Psychoneuroendocrinology. 2007;32(7):834–42.

    Article  CAS  PubMed  Google Scholar 

  25. Sanacora G, Mason GF, Rothman DL, Krystal JH. Increased occipital cortex GABA concentrations in depressed patients after therapy with selective serotonin reuptake inhibitors. Am J Psychiatry. 2002;159:663–5.

    Article  PubMed  Google Scholar 

  26. Zarate Jr CA, Singh JB, Carlson PJ, et al. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry. 2006;63(8):856–64.

    Article  CAS  PubMed  Google Scholar 

  27. Rajkowska G, O’Dwyer G, Teleki Z, Stockmeier CA, Miguel-Hidalgo JJ. GABAergic neurons immunoreactive for calcium binding proteins are reduced in the prefrontal cortex in major depression. Neuropsychopharmacology. 2007;32:471–82.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Vezzani A, Conti M, De Luigi A, Ravizza T, Moneta D, Marchesi F, De Simoni MG. Interleukin-1beta immunoreactivity and microglia are enhanced in the rat hippocampus by focal kainate application: functional evidence for enhancement of electrographic seizures. J Neurosci. 1999;19:5054–65.

    CAS  PubMed  Google Scholar 

  29. Vezzani A, Moneta D, Conti M, Richichi C, Ravizza T, De Luigi A, et al. Powerful anticonvulsant action of IL-1 receptor antagonist on intracerebral injection and astrocytic overexpression in mice. Proc Natl Acad Sci U S A. 2000;97:11534–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. Vezzani A, Balosso S, Ravizza T. The role of cytokines in the pathophysiology of epilepsy. Brain Behav Immun. 2008;22:797–803.

    Article  CAS  PubMed  Google Scholar 

  31. Mendez MF, Cummings JL, Benson DF. Depression in epilepsy. Significance and phenomenology. Arch Neurol. 1986;43(8):766–70.

    Article  CAS  PubMed  Google Scholar 

  32. Kraepelin E. Psychiatrie, vol. 3. Leipzig: Barth; 1923.

    Google Scholar 

  33. Blumer D, Zielinksi J. Pharmacologic treatment of psychiatric disorders associated with epilepsy. J Epilepsy. 1988;1:135–50.

    Article  Google Scholar 

  34. Mula M, Jauch R, Cavanna A, Collimedaglia L, Barbagli D, Gaus V, et al. Clinical and psychopathological definition of the interictal dysphoric disorder of epilepsy. Epilepsia. 2008;49(4):650–6.

    Article  PubMed  Google Scholar 

  35. Kanner AM, Barry JJ, Gilliam F, Hermann B, Meador KJ. Anxiety disorders, subsyndromic depressive episodes, and major depressive episodes: do they differ on their impact on the quality of life of patients with epilepsy? Epilepsia. 2010;51(7):1152–8.

    Article  PubMed  Google Scholar 

  36. Blanchet P, Frommer GP. Mood change preceding epileptic seizures. J Nerv Ment Dis. 1986;174(8):471–6.

    Article  CAS  PubMed  Google Scholar 

  37. Williams D. The structure of emotions reflected in epileptic experiences. Brain. 1956;79(1):29–67.

    Article  CAS  PubMed  Google Scholar 

  38. Daly D. Ictal affect. Am J Psychiatry. 1958;115(2):97–108.

    Article  CAS  PubMed  Google Scholar 

  39. Weil A. Depressive reactions associated with temporal lobe uncinate seizures. J Nerv Ment Dis. 1955;121:505–10.

    Article  CAS  PubMed  Google Scholar 

  40. Kanner AM, Soto A, Gross-Kanner H. Prevalence and clinical characteristics of postictal psychiatric symptoms in partial epilepsy. Neurology. 2004;62(5):708–13.

    Article  PubMed  Google Scholar 

  41. Landoldt H. Some clinical electroencephalographical correlations in epileptic psychosis (twilight states). Electroencephalogr Clin Neurophysiol. 1953;5:121 (abstract).

    Google Scholar 

  42. Savard G, Andermann LF, Reutens D, Andermann F. Epilepsy, surgical treatment and postoperative psychiatric complications: A re-evaluation of the evidence. In: Trimble M, Schmitz B, editors. Forced normalization and alternative psychosis of epilepsy. Petersfield: Writson Biomedical Publishing Ltd.; 1998. p. 179–92.

    Google Scholar 

  43. McConnell H, Duncan D. Chapter 10: Treatment of psychiatric comorbidity in epilepsy. In: McConnell H, Snyder P, editors. Psychiatric comorbidity in epilepsy. Washington: American Psychiatric Press; 1998. p. 245–361.

    Google Scholar 

  44. Barabas G, Matthews WS. Barbiturate anticonvulsants as a cause of severe depression. Pediatrics. 1988;82(2):284–5.

    CAS  PubMed  Google Scholar 

  45. Brent DA, Crumrine PK, Varma RR, Allan M, Allman C. Phenobarbital treatment and major depressive disorder in children with epilepsy. Pediatrics. 1987;80(6):909–17.

    CAS  PubMed  Google Scholar 

  46. Ferrari M, Barabas G, Matthews WS. Psychologic and behavioral disturbance among epileptic children treated with barbiturate anticonvulsants. Am J Psychiatry. 1983;140(1):112–3.

    Article  CAS  PubMed  Google Scholar 

  47. Ring HA, Reynolds EH. Vigabatrin and behaviour disturbance. Lancet. 1990;335(8695):970.

    Article  CAS  PubMed  Google Scholar 

  48. McConnell H, Snyder PJ, Duffy JD, Weilburg J, Valeriano J, Brillman J, et al. Neuropsychiatric side effects to treatment with Felbamate. J Neuropsych Clin Neurosci. 1996;8(3):341–6.

    Article  CAS  Google Scholar 

  49. Mula M, Trimble MR, Yuen A, Liu RS, Sander JW. Psychiatric adverse events during levetiracetam therapy. Neurology. 2003;61:704–6.

    Article  CAS  PubMed  Google Scholar 

  50. Trimble RM, Rϋsch N, Betts T, Crawford PM. Psychiatric symptoms after therapy with new antiepileptic drugs: psychopathological and seizure related variables. Seizure. 2000;9:249–54.

    Article  CAS  PubMed  Google Scholar 

  51. Ketter TA, Malow BA, Flamini R, White SR, Post RM, Theodore WH. Anticonvulsant withdrawal-emergent psychopathology. Neurology. 1994;44(1):55–61.

    Article  CAS  PubMed  Google Scholar 

  52. Barclay L. FDA requires warnings about suicidality risk with antiepileptic drugs. Medscape Medical News. 2008. http://www.medscape.com/viewarticle/585541.

  53. Hesdorffer DC, Kanner AM. The FDA alert on suicidality and antiepileptic drugs: fire or false alarm? Epilepsia. 2009;50(5):978–86.

    Article  PubMed  Google Scholar 

  54. Kanner AM, Balabanov AJ. Chapter 133a: Psychiatric outcome of epilepsy surgery. In: Lüders HO, Bongaman W, Najim IM, editors. Textbook of epilepsy surgery. 3rd ed. London: Informa Healthcare; 2008. p. 1254–62.

    Chapter  Google Scholar 

  55. Koch-Stoecker S. Psychiatric effects of surgery for temporal lobe epilepsy. In: Trimble M, Schmitz B, editors. The neuropsychiatry of epilepsy. Cambridge: Cambridge University Press; 2002. p. 266–82.

    Chapter  Google Scholar 

  56. Fazel S, Wolf A, Långström N, Newton CR, Lichtenstein P. Premature mortality in epilepsy and the role of psychiatric comorbidity: a total population study. Lancet. 2013;382(9905):1646–54.

    Article  PubMed Central  PubMed  Google Scholar 

  57. Christensen J, Vestergaard M, Mortensen PB, Sidenius P, Agerbo E. Epilepsy and risk of suicide: a population-based case-control study. Lancet Neurol. 2007;6(8):693–8.

    Article  PubMed  Google Scholar 

  58. Jones JE, Hermann BP, Barry JJ, Gilliam FG, Kanner AM, Meador KJ. Rates and risk factors for suicide, suicidal ideation, and suicide attempts in chronic epilepsy. Epilepsy Behav. 2003;4(3):31–8.

    Article  Google Scholar 

  59. Perucca P, Jacoby A, Marson AG, Baker GA, Lane S, Benn EK, Thurman DJ, et al. Adverse antiepileptic drug effects in new-onset seizures: a case-control study. Neurology. 2011;76(3):273–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  60. Kanner AM, Barry JJ, Gilliam F, Hermann B, Meador KJ. Depressive and anxiety disorders in epilepsy: do they differ in their potential to worsen common antiepileptic drug-related adverse events? Epilepsia. 2012;53(6):1104–8.

    Article  PubMed  Google Scholar 

  61. Petrovski S, Szoeke CE, Jones NC, Salzberg MR, Sheffield LJ, Huggins RM, O’Brien TJ. Neuropsychiatric symptomatology predicts seizure recurrence in newly treated patients. Neurology. 2010;75(11):1015–21.

    Article  CAS  PubMed  Google Scholar 

  62. Hitiris N, Mohanraj R, Norrie J, Sills GJ, Brodie MJ. Predictors of pharmacoresistant epilepsy. Epilepsy Res. 2007;75(2–3):192–6.

    Article  CAS  PubMed  Google Scholar 

  63. Kanner AM, Byrne R, Chicharro A, Wuu J, Frey M. A lifetime psychiatric history predicts a worse seizure outcome following temporal lobectomy. Neurology. 2009;72(9):793–9.

    Article  CAS  PubMed  Google Scholar 

  64. Cleary RA, Thompson PJ, Fox Z, Foong J. Predictors of psychiatric and seizure outcome following temporal lobe epilepsy surgery. Epilepsia. 2012;53(10):1705–12.

    Article  PubMed  Google Scholar 

  65. de Araújo Filho GM, Gomes FL, Mazetto L, Marinho MM, Tavares IM, Caboclo LO, et al. Major depressive disorder as a predictor of a worse seizure outcome one year after surgery in patients with temporal lobe epilepsy and mesial temporal sclerosis. Seizure. 2012;8:619–23.

    Article  Google Scholar 

  66. Cramer JA, Blum M, Reed M, Fanning K, Project EI. The influence of comorbid depression on quality of life for people with epilepsy. Epilepsy Behav. 2003;4:515–21.

    Article  PubMed  Google Scholar 

  67. Lehrner J, Kalchmayr R, Serles W, Olbrich A, Pataraia E, Aull S, et al. Health-related quality of life (HRQOL), activity of daily living (ADL) and depressive mood disorder in temporal lobe epilepsy patients. Seizure. 1999;8(2):88–92.

    Article  CAS  PubMed  Google Scholar 

  68. Gilliam F, Kuzniecky R, Faught E, Black L, Carpenter G, Schrodt R. Patient-validated content of epilepsy-specific quality-of-life measurement. Epilepsia. 1997;38(2):233–6.

    Article  CAS  PubMed  Google Scholar 

  69. Perrine K, Hermann BP, Meador KJ, Vickrey BG, Cramer JA, Hays RD, Devinsky O. The relationship of neuropsychological functioning to quality of life in epilepsy [see comments]. Arch Neurol. 1995;52(10):997–1003.

    Article  CAS  PubMed  Google Scholar 

  70. Cramer JA, Blum D, Fanning K, Reed M, Epilepsy Impact Project Group. The impact of comorbid depression on health resource utilization in a community sample of people with epilepsy. Epilepsy Behav. 2004;5:337–42.

    Article  PubMed  Google Scholar 

  71. Jones JE, Watson R, Sheth R, Caplan R, Koehn M, Seidenberg M, Hermann B. Psychiatric comorbidity in children with new onset epilepsy. Dev Med Child Neurol. 2007;49(7):493–7.

    Article  PubMed  Google Scholar 

  72. Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146:317–25.

    Article  PubMed  Google Scholar 

  73. Barry JJ, Ettinger AB, Friel P, Gilliam FG, Harden CL, Hermann B, et al. Consensus statement: the evaluation and treatment of people with epilepsy and affective disorders. Epilepsy Behav. 2008;13(Suppl1):S1–29.

    Article  PubMed  Google Scholar 

  74. Kerr MP, Mensah S, Besag F, de Toffol B, Ettinger A, Kanemoto K, et al. International consensus clinical practice statements for the treatment of neuropsychiatric conditions associated with epilepsy. Epilepsia. 2011;52(11):2133–8.

    Article  PubMed  Google Scholar 

  75. Fritze J, Unsorg B, Lanczik M. Interaction between carbamazepine and fluvoxamine. Acta Psychiatr Scand. 1991;84(6):583–4.

    Article  CAS  PubMed  Google Scholar 

  76. Grimsley SR, Jann MW, Carter JG, D’Mello AP, D'SouzaM J. Increased carbamazepine plasma concentrations after fluoxetine coadministration. Clin Pharmacol Ther. 1991;50(1):10–5.

    Article  CAS  PubMed  Google Scholar 

  77. Pearson HJ. Interaction of fluoxetine with carbamazepine. J Clin Psychiatry. 1990;51(3):126.

    CAS  PubMed  Google Scholar 

  78. Haselberger MB, Freedman LS, Tolbert S. Elevated serum phenytoin concentrations associated with coadministration of sertraline. J Clin Psychopharmacol. 1997;17(2):107–9.

    Article  CAS  PubMed  Google Scholar 

  79. Fink M, Kellner CH, Sackeim HA. Intractable seizures, status epilepticus, and ECT. J ECT. 1999;15(4):282–4.

    Article  CAS  PubMed  Google Scholar 

  80. Regenold WT, Weintraub D, Taller A. Electroconvulsive therapy for epilepsy and major depression. Am J Geriatr Psychiatry. 1998;6(2):180–3.

    Article  CAS  PubMed  Google Scholar 

  81. Blackwood DH, Cull RE, Freeman CP, Evans JI, Mawdsley C. A study of the incidence of epilepsy following ECT. J Neurol Neurosurg Psychiatry. 1980;43(12):1098–102.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  82. Marangell LB, Rush AJ, George MS, Sackeim HA, Johnson CR, Husain MM, et al. Vagus nerve stimulation (VNS) for major depressive episodes: one year outcomes. Biol Psychiatry. 2002;51(4):280–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Epilepsy Section, Department of Neurology, Comprehensive Epilepsy Center, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Room 1324, Miami, FL, 33136, USA

    Andres M. Kanner MD, FANA & Ramses Ribot MD

  2. EEG Monitoring Unit, University of Miami Hospital, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Room 1324, Miami, FL, 33136, USA

    Andres M. Kanner MD, FANA & Ramses Ribot MD

Authors
  1. Andres M. Kanner MD, FANA
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ramses Ribot MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andres M. Kanner MD, FANA .

Editor information

Editors and Affiliations

  1. Atkinson Morley Regional Neuroscience Centre, Epilepsy Group, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom

    Marco Mula

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Kanner, A.M., Ribot, R. (2016). Depression. In: Mula, M. (eds) Neuropsychiatric Symptoms of Epilepsy. Neuropsychiatric Symptoms of Neurological Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-22159-5_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-22159-5_2

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22158-8

  • Online ISBN: 978-3-319-22159-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation