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Comorbid Depressive Disorders in Epilepsy

Published online by Cambridge University Press:  07 November 2014

Extract

A 27-year-old woman presented to the emergency room after having witnessed generalized tonic clonic seizure while asleep. Birth and development were normal. She had suffered a single febrile seizure at 13 months of age, but had no other seizure risk factors. She was otherwise well except for a history of depression for which she was taking sertraline. Depressive symptoms had been well controlled over the past 3 months, but she had been under increased stress working to finish a doctoral thesis. Neurological examination was normal. Magnetic resonance imaging (MRI) showed modest asymmetry of the hippocampi, slightly smaller on the right, but no abnormal signal and well-preserved laminar anatomy. An electroencephalogram was negative. She was discharged from the emergency room with no treatment. Three weeks later, the patient's boyfriend witnessed an episode of behavioral arrest with lip smacking and swallowing automatisms lasting 45 seconds, after which the patient was confused for 20–30 minutes. The next morning she and her boyfriend kept a previously scheduled appointment with a neurologist.

Type
Expert Review Supplement
Copyright
Copyright © Cambridge University Press 2010

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References

1.Tellez-Zenteno, JF, Patten, SB, Jetté, N, Williams, J, Wiebe, S. Psychiatric comorbidity in epilepsy: a population-based analysis. Epilepsia. 2007;48:23362344.Google Scholar
2.Forsgren, L, Nystrom, L. An incident case-referent study of epileptic seizures in adults. Epilepsy Res. 1990;6:6681.CrossRefGoogle ScholarPubMed
3.Hesdorffer, DC, Hauser, WA, Annegers, JF, Cascino, G. Major depression is a risk factor for seizures in older adults. Ann Neurol. 2000;47:246249.Google Scholar
4.Hesdorffer, DC, Hauser, WA, Olafsson, E, Ludvigsson, P, Kjartansson, O. Depression and suicidal attempt as risk factor for incidental unprovoked seizures. Ann Neurol. 2006;59:3541.CrossRefGoogle Scholar
5.Christensen, J, Vestergaard, M, Mortensen, P, Sidenius, P, Agerbo, E. Epilepsy and risk of suicide: a population-based case—control study. Lancet Neurol. 2007;6:693698.CrossRefGoogle ScholarPubMed
6.Lehrner, J, Kalchmayr, R, Serles, W et al. , Health-related quality of life (HRQOL), activity of daily living (ADL) and depressive mood disorder in temporal lobe epilepsy patients. Seizure. 1999;8:8892.Google Scholar
7.Perrine, K, Hermann, BP, Meador, KJ et al. , The relationship of neuropsychological functioning to quality of life in epilepsy. Arch Neurol. 1995;52:9971003.Google Scholar
8.Gilliam, F, Kuzniecky, R, Faught, E et al. , Patient-validated content of epilepsy-specific quality-of-life measurement. Epilepsia. 1997;38:233236.Google Scholar
9.Boylan, LS, Flint, LA, Labovitz, DL, Jackson, SC, Starner, K, Devinsky, O. Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy. Neurology. 2004;62:258261.Google Scholar
10.Cramer, JA, Blum, M, Reed, M, Fanning, K, Epilepsy Impact Project. The influence of comorbid depression on quality of life for people with epilepsy. Epilepsy Behav. 2003;4:515521.Google Scholar
11.Cramer, JA, Blum, D, Fanning, K, Reed, M, Epilepsy Impact Project Group. The impact of comorbid depression on health resource utilization in a community sample of people with epilepsy. Epilepsy Behav. 2004;5:337342.Google Scholar
12.Hitiris, N, Mohanraj, R, Norrie, J, Sills, GJ, Brodie, MJ. Predictors of pharmacoresistant epilepsy. Epilepsy Res. 2007;75:192196.Google Scholar
13.Kanner, AM, Byrne, R, Chicharro, A, Wuu, J, Frey, M. A lifetime psychiatric history predicts a worse seizure outcome following temporal lobectomy. Neurology. 2009;72:793799.Google Scholar
14.Kanner, AM, Balabanov, A. Depression in epilepsy: how closely related are these two disorders? Neurology. 2002;58(suppl 5):2739.CrossRefGoogle Scholar
15.Kanner, AM. Depression and epilepsy: why is their relation is so close? Neurol Clin N Am. 2009;27:865880.Google Scholar
16.Kanner, AM. Depression and epilepsy: do glucocorticoids and glutamate explain their relationship? Curr Neurol Neurosci Rep. 2009;9:307312.Google Scholar
17.Kanner, AM. Mood disorder and epilepsy: a neurobiologic perspective of their relationship. Dialogues Clin Neurosci. 2008;10:3945.Google Scholar
18.Kanner, AM. Current review in clinical science: depression in epilepsy: a neurobiologic perspective. Epilepsy Curr. 2005;5:2127.Google Scholar
19.Diagnostic and Statistical Manuel of Mental Disorders. 4th ed, text rev. Washington, DC: American Psychiatric Association; 2000.Google Scholar
20.Kraepelin, E. Psychiatrie, vol 3. Leipzig: Johann Ambrosius Barth, 1923.Google Scholar
21.Bleuler, E. Lehrbuch der Psychiatrie. 8th ed.Berlin: Springer, 1949.Google Scholar
22.Blumer, D, Altshuler, LL. Affective disorders. In: Engel, J, Pedley, TA, eds. Epilepsy: A Comprehensive Textbook, vol 2. Philadelphia, PA: Lippincott-Raven; 1998:20832099.Google Scholar
23.Blanchet, P, Frommer, GP. Mood change preceding epileptic seizures. J Nerv Ment Dis. 1986;174:471476.Google Scholar
24.Kanner, AM, Soto, A, Gross-Kanner, H. Prevalence and clinical characteristics of postictal psychiatric symptoms in partial epilepsy. Neurology. 2004;62:708713.Google Scholar
25.Jones, JE, Herman, BP, Berry, JJ, Gilliam, F, Kanner, AM, Meador, KJ. Clinical assessment of Axis I psychiatric morbidity in chronic epilepsy: a multicenter investigation. J Neuropsychiatry Clin Neurosci. 2005;17:172179.Google Scholar
26.Jones, JE, Hermann, BP, Barry, JJ, Gilliam, FG, Kanner, AM, Meador, KJ. Rates and risk factors for suicide, suicidal ideation, and suicide attempts in chronic epilepsy. Epilepsy Behav. 2003;4(suppl 3):3138.CrossRefGoogle ScholarPubMed
27.Labiner, DM, Ettinger, AB, Fakhoury, TA et al. , Effects of lamotrigine compared with levetiracetam on anger, hostility, and total mood in patients with partial epilepsy. Epilepsia. 2009;50:434442.Google Scholar
28.Fakhoury, TA, Miller, JM, Hammer, AE, Vuong, A. Effects of lamotrigine on mood in older adults with epilepsy and co-morbid depressive symptoms: an open-label, multicentre, prospective study. Drugs Aging. 2008;25:955962.CrossRefGoogle ScholarPubMed
29.Fakhoury, TA, Barry, JJ, Mitchell Miller, J, Hammer, AE, Vuong, A. Lamotrigine in patients with epilepsy and comorbid depressive symptoms. Epilepsy Behav. 2007;10:155162.Google Scholar
30.Charney, DS, Berman, RM, Miller, HL. Treatment of depression. In: Schatzberg, AF, Nemeroff, CB, eds. Textbook of Psychopharmacology. 2nd ed.Washington, DC: American Psychiatric Association Press; 1998: 705732.Google Scholar
31.U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research, Office of Translational Sciences, Office of Biostatistics (2008). Statistical review and evaluation: Antiepileptic drugs and suicidality. May 21, 2008.Google Scholar
32.Hesdorffer, DC, Kanner, AM. The FDA alert on suicidality and antiepileptic drugs: fire or false alarm? Epilepsia. 2009;50:978986.CrossRefGoogle ScholarPubMed
33.Gilliam, FG, Barry, JJ, Hermann, BP, Meador, KJ, Vahle, V, Kanner, AM. Rapid detection of major depression in epilepsy: a multicentre study. Lancet Neurol. 2006;5:399405.CrossRefGoogle ScholarPubMed
34.Kroenke, K, Spitzer, RL, Williams, JB, Monahan, PO, Löwe, B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146:317325.Google Scholar