Depressive and anxiety disorders in epilepsy

Do they differ in their potential to worsen common antiepileptic drug-related adverse events?

Andres M Kanner, John J. Barry, Frank Gilliam, Bruce Hermann, Kimford J. Meador

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Purpose: To compare the effect of anxiety disorders, major depressive episodes (MDEs), and subsyndromic depressive episodes (SSDEs) on antiepileptic drug (AED)-related adverse events (AEs) in persons with epilepsy (PWE). Methods: The study included 188 consecutive PWE from five U.S. outpatient epilepsy clinics, all of whom underwent structured interviews (SCID) to identify current and past mood disorders and other current Axis I psychiatric diagnoses according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria. A diagnosis of SSDE was made in patients with total Beck Depression Inventory-II (BDI-II) scores >12 or the Centers of Epidemiologic Studies-Depression (CES-D) > 16 (in the absence of any DSM diagnosis of mood disorder. The presence and severity of AEs was measured with the Adverse Event Profile (AEP). Key Findings: Compared to asymptomatic patients (n = 103), the AEP scores of patients with SSDE (n = 26), MDE only (n = 10), anxiety disorders only (n = 21), or mixed MDE/anxiety disorders (n = 28) were significantly higher, suggesting more severe AED-related AEs. Univariate analyses revealed that having persistent seizures in the last 6 months and taking antidepressants was associated with more severe AEs. Post hoc analyses, however, showed that these differences were accounted for by the presence of a depressive and/or anxiety disorders. Significance: Depressive and anxiety disorders worsen AED-related AEs even when presenting as a subsyndromic type. These data suggest that the presence of psychiatric comorbidities must be considered in their interpretation, both in clinical practice and AED drug trials.

Original languageEnglish (US)
Pages (from-to)1104-1108
Number of pages5
JournalEpilepsia
Volume53
Issue number6
DOIs
StatePublished - 2012
Externally publishedYes

Fingerprint

Depressive Disorder
Anxiety Disorders
Anticonvulsants
Epilepsy
Mood Disorders
Diagnostic and Statistical Manual of Mental Disorders
Depression
Ambulatory Care Facilities
Mental Disorders
Antidepressive Agents
Psychiatry
Comorbidity
Epidemiologic Studies
Seizures
Interviews
Equipment and Supplies
Pharmaceutical Preparations

Keywords

  • Antidepressant medication
  • Generalized anxiety disorder
  • Pharmacoresistant epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Depressive and anxiety disorders in epilepsy : Do they differ in their potential to worsen common antiepileptic drug-related adverse events? / Kanner, Andres M; Barry, John J.; Gilliam, Frank; Hermann, Bruce; Meador, Kimford J.

In: Epilepsia, Vol. 53, No. 6, 2012, p. 1104-1108.

Research output: Contribution to journalArticle

Kanner, Andres M ; Barry, John J. ; Gilliam, Frank ; Hermann, Bruce ; Meador, Kimford J. / Depressive and anxiety disorders in epilepsy : Do they differ in their potential to worsen common antiepileptic drug-related adverse events?. In: Epilepsia. 2012 ; Vol. 53, No. 6. pp. 1104-1108.
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