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

75 Scopus citations

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 - Jun 2012
Externally publishedYes

Keywords

  • Antidepressant medication
  • Generalized anxiety disorder
  • Pharmacoresistant epilepsy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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