Epilepsy and Depression

Abstract

Epilepsy and depression are frequently associated. The relationship between them seems to be reciprocal. Epilepsy predisposes to depression and people with depression have a higher risk of developing epilepsy than general population. Seizures usually start in the first months after the debut of depression. The cause of this association is multiple. In one way, numerous neurobiological factors may be responsible simultaneously of both disorders. Some encephalic structures, like hippocampus, amygdala, orbitofrontal cortex, and cerebellum are implicated in emotional control and pathogenesis of seizures. Moreover, the disequilibrium in the action of different neurotransmitters, like glutamate, GABA and serotonin, is related with both depression and epilepsy. Finally, dysfunction in hypothalamus-pituitary-adrenal axis is also related with both diseases. People with epilepsy are also exposed to social discrimination and stigma, which can be in part responsible of mood disorders. Antiepileptic drugs have a psychotropic profile, different from one to another, which can induce or aggravate depression. Early diagnosis of mood disorders in people with epilepsy is crucial, because they determine the quality of life, may worsen the adherence to the treatment and increase the sensibility to side effects of drugs. Moreover, it is important to consider this possibility when choosing the most adequate antiepileptic drug without aggravating psychiatric comorbidity. If depression is detected, it should be treated effectively. Nowadays we know that most antidepressants are secure in people with epilepsy. © 2019 Publicaciones Permanyer. All rights reserved.