Epilepsy in Psychiatric Disorders

Abstract

Around 20 % of people with intellectual disability (ID) develop epileptic seizures. ID is a risk factor for the development of epileptic seizures also in patients with autism (21.5 % vs 8 % in the general population). In both these conditions generalized seizures are more common than partial seizures. The incidence of epilepsy is four to seven times higher in patients with depression than in the general population. Epilepsy and depression share an unusually high co-occurrence leading to a common etiology. A lifetime history of depression is also associated with a worse seizure outcome even after anterior temporal lobectomy. Patients treated with an antidepressant have a 50 % reduction in the occurrence of seizures. Epilepsy and bipolar disorder also could share a number of biochemical and pathophysiological underpinnings, even though the current literature is scarce. Patients with schizophrenia have an 11-fold increase in the prevalence of comorbid epilepsy. At therapeutic doses, drugs with high epileptogenic potential include clozapine and phenothiazines; drugs with intermediate epileptogenic potential include maprotiline and tricyclic antidepressants, while drugs with low epileptogenic potential include bupropion. The antidepressants with higher seizure potential after overdose are imipramine, desipramine, nortriptyline, maprotiline, and bupropion. (PsycINFO Database Record (c) 2016 APA, all rights reserved)