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Komorbidität Depression bei Epilepsie

Comorbidity of depression in people with epilepsy

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Zusammenfassung

Depression ist neben der Angsterkrankung die häufigste Komorbidität bei Menschen mit Epilepsie (MmE). Bei Auftreten dieser Komorbidität ist die Lebensqualität signifikant reduziert und das Risiko für Suizidalität drastisch erhöht – insbesondere in den ersten 12 Monaten nach Diagnosestellung der Epilepsie. Es kann zu einer Zunahme der Anfallsfrequenz kommen. Depression bei MmE wird häufig nicht erkannt und behandelt. Es ist daher ratsam, Screenings für Depression durchzuführen. Der ursächliche Zusammenhang dieser Komorbiditäten ist ungeklärt. Therapeutische Optionen sind die Optimierung der Antiepileptikatherapie, Antidepressiva, insbesondere selektive Wiederaufnahmehemmer, kognitive Verhaltenstherapie und Vagus-Nerv-Stimulator. Klinische Studien für die Wirksamkeit dieser Behandlungen sind unzureichend und werden in Zukunft dringend benötigt.

Abstract

Depression next to anxiety is the most common comorbidity in epilepsy. Depression in people with epilepsy (PwE) reduces quality of life and increases suicide risk especially in the first year after diagnosis of epilepsy. Depression causes an increase in seizure frequency. Depression in PwE is often missed. Screening tools increase the detection rate for depression in this patient group. The underlying mechanism of this comorbidity is still debated. Therapeutic options include optimizing anticonvulsive drugs, antidepressants particularly selective reuptake inhibitors, cognitive behavioral therapy, and in drug refractory epilepsy vagal nerve stimulation. Data on the effects of those therapies are sparse and clinical studies in this patient group are urgently needed.

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Author information

Authors and Affiliations

  1. Klinik für Neurologie 1, Kepler Universitätsklinikum – Neuromed Campus, Wagner-Jauregg Weg 15, 4020, Linz, Österreich

    Tim J. von Oertzen FRCP, FEAN

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  1. Tim J. von Oertzen FRCP, FEAN
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Correspondence to Tim J. von Oertzen FRCP, FEAN.

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Interessenkonflikt

T.J. von Oertzen berichtet Honorare für Berater- oder Vortragstätigkeit und Fortbildungsunterstützung von der Firma Eisai Pharma GmbH, Wien, Forschungsförderung, Honorare für Berater- oder Vortragstätigkeit und Fortbildungsunterstützung von der Firma UCB Pharma GmbH Wien, Fortbildungsunterstützung von der Firma Medtronic Österreich GmbH, Forschungsförderung, Honorare für Berater- oder Vortragstätigkeit und Fortbildungsunterstützung von der Firma Novartis Pharma, Honorare für Berater- oder Vortragstätigkeit von den Firmen Biogen Idec Austria, Liva-Nova und Sanofi-Genzyme GmbH, Forschungsförderung von der Firma Grossegger & Drbal GmbH außerhalb der vorgelegten Arbeit erhalten zu haben. Er ist Webeditor in-chief der European Academy of Neurology (EAN) und Mitglied der Management Group des Scientific Panel für Epilepsie (EAN) und Vizepräsident der Österreichischen Gesellschaft für Epileptologie und gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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von Oertzen, T.J. Komorbidität Depression bei Epilepsie. Z. Epileptol. 31, 28–33 (2018). https://doi.org/10.1007/s10309-017-0149-7

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  • DOI: https://doi.org/10.1007/s10309-017-0149-7

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