Alkhaldi Norah A
Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi Arabia.
Heliyon. 2024 Dec 25;11(1):e41389. doi: 10.1016/j.heliyon.2024.e41389. eCollection 2025 Jan 15.
Epilepsy presents a significant global health challenge, impacting millions worldwide. Alarmingly, over half of individuals living with epilepsy (PWE) also face concurrent medical conditions, with psychiatric complications, particularly depression, standing out as prevalent issues. The relationship between epilepsy and depression is complex and bidirectional, with approximately a quarter of adults with epilepsy receiving a diagnosis of depression. This complexity underscores the challenges in diagnosing depression in epilepsy patients, hindered by overlapping symptoms and distinct manifestations of depression in this population. Our review highlights that the use of most antidepressant pharmacotherapies does not increase the risk of seizure occurrences. On the contrary, compelling evidence suggests that such treatments may even decrease seizure frequency, offering hope for patients. In addition to pharmacology, non-pharmacological interventions are emerging as vital alternatives, enriching the therapeutic landscape. However, despite these promising avenues, a significant gap in our understanding persists, characterized by a lack of comprehensive, prospective research. Our review rigorously explores the latest pathophysiological insights linking depression and epilepsy while critically evaluating contemporary treatment paradigms for individuals grappling with these comorbid conditions. By focusing on the most current developments, this review aims to equip clinicians with cutting-edge knowledge, fostering a more nuanced and effective approach to managing the intricate interplay between epilepsy and comorbid depression.
癫痫是一项重大的全球健康挑战，影响着全球数百万人。令人担忧的是，超过半数的癫痫患者（PWE）还同时患有其他疾病，其中精神并发症，尤其是抑郁症，是普遍存在的问题。癫痫与抑郁症之间的关系复杂且具有双向性，约四分之一的成年癫痫患者被诊断出患有抑郁症。这种复杂性凸显了癫痫患者抑郁症诊断的挑战，该人群中抑郁症症状重叠且表现各异，给诊断带来了阻碍。我们的综述强调，大多数抗抑郁药物治疗并不会增加癫痫发作的风险。相反，有力证据表明，此类治疗甚至可能降低癫痫发作频率，为患者带来了希望。除了药物治疗，非药物干预正成为重要的替代方法，丰富了治疗手段。然而，尽管有这些有前景的途径，但我们的认识仍存在重大差距，其特点是缺乏全面的前瞻性研究。我们的综述严谨地探讨了将抑郁症与癫痫联系起来的最新病理生理学见解，同时批判性地评估了针对患有这些合并症的个体的当代治疗模式。通过关注最新进展，本综述旨在为临床医生提供前沿知识，促进采用更细致入微且有效的方法来管理癫痫与合并症抑郁症之间的复杂相互作用。
