Review
Epilepsy, depression and antidepressant drugs

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Abstract

Apart from constituting an important management problem, depression coexisting with epilepsy is also an interesting psychiatric phenomenon, with multiple interacting biological, psychological and social factors involved in its causation. New research ap proaches to the study of epilepsy and depression, including neuroimaging, neurochemical and neuroendocrine techniques, and the arrival of new classes of antidepressants in recent years, suggest it is timely to reconsider this topic. We review current knowledge of the prevalence and causes of interictal depression in epilepsy, focussing mainly on neurobiological factors, and give an overview of recent concepts concerning the management of depression. We also discuss pharmacological treatment of depressio n in epilepsy, focussing on the association between antidepressants and seizures, and drug interactions.

References (110)

  • V Westerberg et al.

    Depletion of noradrenaline fails to affect kindled seizures

    Expe Neurol

    (1984)
  • M Kokaia

    Noradrenergic mechanisms in hippocampal kindling with rapidly recurring seizures

    Brain Res

    (1989)
  • G Wedin

    Relative toxicity of cyclic antidepressants

    Ann Emerg Med

    (1986)
  • M Segal

    Serotonin attenuates a slow inhibitory postsynaptic potential in rat hippocampal neurons

    Neuroscience

    (1990)
  • RS Sloviter et al.

    On the relationship between kainic acid-induced epileptiform activity and hippocampal neuronal damage

    Neuropharmacology

    (1981)
  • G Sperk

    Kainic acid induced seizures: neurochemical and histopathological changes

    Neuroscience

    (1983)
  • G Sperk

    Kainic acid induced seizures: changes in somatostatin, substance P and neurotensin

    Neuroscience

    (1986)
  • M Robertson

    Mood disorders associated with epilepsy

  • MV Lambert et al.

    Depression in epilepsy: etiology, phenomenology, and treatment

    Epilepsia

    (1999)
  • D Blumer et al.

    Affective disorders

  • DG Blazer

    The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey

    Am J Psychiatry

    (1994)
  • HA Ring et al.

    A prospective study of the early postsurgical psychiatric associations of epilepsy surgery

    J Neurol Neurosurger Psychiatry

    (1998)
  • AS Naylor

    Psychiatric morbidity after surgery for epilepsy: short-term follow up of patients undergoing amygdalohippocampectomy

    J Neurol Neurosurg Psychiatry

    (1994)
  • P Wiegartz

    Co-morbid psychiatric disorder in chronic epilepsy: recognition and etiology of depression

    Neurology

    (1999)
  • G Perini

    Research Diagnostic Criteria (RDC) mental disorder and self-reported symptoms in outpatients with complex partial seizures

    Int J Psychiatry Med

    (1987)
  • GI Perini

    Interictal mood and personality disorders in temporal lobe epilepsy and juvenile myoclonic epilepsy

    J Neurol Neurosurg Psychiatry

    (1996)
  • EB Schmitz

    Psychiatric profiles and patterns of cerebral blood flow in focal epilepsy: interactions between depression, obsessionality, and perfusion related to the laterality of the epilepsy

    J Neurol Neurosurg Psychiatry

    (1997)
  • J Victoroff

    Depression in complex partial seizures: electroencephalography and cerebral metabolic correlates

    Arch Neurol

    (1994)
  • E Bromfield

    Cerebral metabolism and depression in patients with complex partial seizures (abstract)

    Epilepsia

    (1990)
  • HS Mayberg

    Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness

    Am J Psychiatry

    (1999)
  • D Blumer et al.

    Psychiatric morbidity in seizure patients on a neurodiagnostic monitoring unit

    J Neuropsychiatry Clin Neurosci

    (1995)
  • D Blumer

    Dysphoric disorders and paroxysmal affects: recognition and treatment of epilepsy-related psychiatric disorders

    Harvard Review of Psychiatry

    (2000)
  • R Sapolsky et al.

    The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis

    Endocrine Reviews

    (1986)
  • B McEwen et al.

    Stress effects on morphology and function of the hippocampus

    Ann NY Acad Sci

    (1997)
  • R Post et al.

    Shared mechanisms in affective illness, epilepsy, and migraine

    Neurology

    (1994)
  • P Smith et al.

    Neural mechanisms of psychiatric disturbances in patients with epilepsy

  • B Jarrott

    Epileptogenesis: biochemical aspects

  • S Garlow et al.

    The neurochemistry of mood disorders: clinical studies

  • Musselman, D, Biology of mood disorders, The American Psychiatric Press Textbook of Psychopharmacology, Schatzberg,...
  • MR Salzberg

    Temporal lobe epilepsy surgery, depression and the HPA axis: an hypothesis

    (1998)
  • R Adamec

    Corticotrophin releasing factor – a peptide link between stress and psychopathology associated with epilepsy?

    Journal of Psychopharmacology

    (1991)
  • S Heit

    Corticotropin-releasing factor, stress, and depression

    The Neuroscientist

    (1997)
  • F Holsboer et al.

    Antidepressants and hypothalamic-pituitary-adrenocortical regulation

    Endocrine Reviews

    (1996)
  • B Gallagher

    Endocrine abnormalities in human temporal lobe epilepsy

    Yale J Biol Med

    (1987)
  • Herzog, A, Neurendocrinology of epilepsy, Schachter, SDevinsky, O, Behavioral neurology and the legacy of Norman...
  • J Engel

    Neurobiological evidence for epilepsy-induced interictal disturbances

  • H Landolt

    Serial electroencephalographic investigations during psychotic episodes in epileptic patients and during schizophrenic attacks

  • ES Krishnamoorthy et al.

    Forced normalization: clinical and therapeutic relevance

    Epilepsia

    (1999)
  • MR Trimble

    Anticonvulsant-induced psychiatric disorders. The role of forced normalisation

    Drug Safety

    (1996)
  • Cited by (0)

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    Correspondence to: Dr M Salzberg, St Vincent's Mental Health Service, 41 Victoria Pde, Fitzroy VIC 3065, Australia. Tel.: +61-3-92884124; Fax: +61-3-92884147

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