Alhashimi Rasha, Thoota Sankeerth, Ashok Tejaswini, Palyam Vishnu, Azam Ahmad T, Odeyinka Oladipo, Sange Ibrahim
Internal Medicine, University of Baghdad College of Medicine, Baghdad, IRQ.
Internal Medicine, Meenakshi Medical College Hospital and Research Institute, Kancheepuram, IND.
Cureus. 2022 Jan 23;14(1):e21527. doi: 10.7759/cureus.21527. eCollection 2022 Jan.
Epilepsy is a neurological disorder characterized by recurrent unprovoked seizures. Depression may arise as a result of other mental or physical problems or as a side effect of the drugs used to treat such illnesses, or it could be caused by epilepsy-related structural abnormalities. However, physicians are hesitant to prescribe antidepressants to patients with epilepsy due to concerns about decreasing seizure thresholds and the harmful drug interactions between antidepressants and antiepileptic medicines. As a result, the question about the optimal care of epileptic patients who suffer from depression remains unanswered. Despite the complicated link between epilepsy and depression, the co-administration of antidepressants and antiepileptic drugs (AEDs) is safe and beneficial when appropriately managed. A focused evaluation for depression (regardless of social, economic, or personal circumstances) might identify people who benefit from medical care and therapeutic assistance. Vagus nerve stimulation and psychological therapies such as cognitive-behavioral therapy, individual or group psychotherapy, patient support groups, family therapy, and counseling are nonpharmacological therapeutic alternatives. In terms of treatment strategy, it is critical to optimize seizure control and limit antiepileptic medications' adverse effects. Psychotherapy for depression in epilepsy is underused, even though it has been shown to be helpful in well-controlled studies. This review article has discussed some parts of the most common pathophysiologies of depression in patients with epilepsy, highlighted the efficacy of psychotherapy and antidepressant drugs, and explored the optimal care of patients with epilepsy who suffer from depression.
癫痫是一种以反复发作的无端癫痫发作为特征的神经系统疾病。抑郁症可能是由其他精神或身体问题引起的，也可能是用于治疗此类疾病的药物的副作用，或者可能是由癫痫相关的结构异常导致的。然而，由于担心降低癫痫发作阈值以及抗抑郁药与抗癫痫药之间有害的药物相互作用，医生对于给癫痫患者开抗抑郁药犹豫不决。因此，关于患有抑郁症的癫痫患者的最佳治疗问题仍然没有答案。尽管癫痫和抑郁症之间的联系很复杂，但在适当管理的情况下，抗抑郁药和抗癫痫药物（AEDs）联合使用是安全且有益的。对抑郁症进行重点评估（无论社会、经济或个人情况如何）可能会识别出能从医疗护理和治疗援助中受益的人。迷走神经刺激以及心理治疗，如认知行为疗法、个体或团体心理治疗、患者支持小组、家庭治疗和咨询，都是非药物治疗选择。在治疗策略方面，优化癫痫控制并限制抗癫痫药物的不良反应至关重要。尽管在严格控制的研究中已证明心理治疗对癫痫患者的抑郁症有帮助，但在癫痫患者抑郁症治疗中，心理治疗的应用不足。这篇综述文章讨论了癫痫患者抑郁症最常见的一些病理生理学方面，强调了心理治疗和抗抑郁药物的疗效，并探讨了患有抑郁症的癫痫患者的最佳治疗方法。
