Kanner Andres M, Gidal Barry E
Rush University Medical Center, Chicago, Illinois, USA.
Int Rev Neurobiol. 2008;83:397-416. doi: 10.1016/S0074-7742(08)00022-6.
Co-morbid psychiatric disorders are relatively frequent in patients with epilepsy. The prevalence rates of mood and anxiety disorders, psychotic disorders and attention deficit/hyperactivity disorder have been found to be significantly higher in patients with epilepsy than in the general population. While co-morbid psychiatric disorders have frequently been considered as complications of the seizure disorder, there is an increasing body of literature that points to a complex relationship between psychiatric and seizure disorders. Because of this, it is crucial that clinicians consider the presence of co-morbid psychiatric disorders when planning the treatment of patients with epilepsy. Having a clear understanding of the pharmacodynamic and pharmacokinetic interactions between antiepileptic drugs and psychotropic drugs is of the essence to avert unnecessary adverse events and loss of efficacy of psychotropic drugs. This chapter provides a practical review on the use of psychotropic drugs for the treatment of these psychiatric co-morbidities in patients with epilepsy.
共病性精神障碍在癫痫患者中较为常见。研究发现,癫痫患者中情绪和焦虑障碍、精神障碍以及注意力缺陷/多动障碍的患病率显著高于普通人群。虽然共病性精神障碍常被视为癫痫发作障碍的并发症,但越来越多的文献表明精神障碍与癫痫发作障碍之间存在复杂的关系。因此,临床医生在规划癫痫患者的治疗方案时,考虑是否存在共病性精神障碍至关重要。清楚了解抗癫痫药物与精神药物之间的药效学和药代动力学相互作用,对于避免不必要的不良事件以及精神药物疗效丧失至关重要。本章对使用精神药物治疗癫痫患者的这些共病性精神障碍进行了实用综述。