Depression and Epilepsy: Comorbidity, Pathogenetic Similarity, and Principles of Treatment

Abstract

The literature has in recent years seen confi rmation of the link between depression and epilepsy, with mutual increases in the severity of both diseases. The presence of depression in patients with epilepsy has been shown to increase the risk of developing fi rst unprovoked episodes, to decrease compliance, to lead to decreases in responses to both pharmacological and surgical treatment, to increase the risk of developing side effects of antiepileptic drugs, and to lead to decreases in overall quality of life. In addition, the presence of depression is linked with a high risk of suicidal behavior. Most cases of depression in epilepsy are characterized by an atypical course, which hinders diagnosis and treatment. The situation is exacerbated by patients’ fear of increases in stigmatization associated with mental illness. In this case, depression becomes the cause of the lack of timely pharmacological and psychotherapeutic intervention. Nonetheless, patients with comorbid depression visit doctors 2–4 times more frequently than those without depression, leading to signifi cant increases in the economic burden for the healthcare system.