This systematic review examines the effectiveness of treatment strategies aimed at addressing psychiatric symptoms and cognitive impairments in children with epilepsy. Pediatric epilepsy is commonly accompanied by mental health challenges such as anxiety, depression, attention difficulties, and problems with executive functioning, all of which can significantly affect quality of life. A thorough search of recent clinical trials was conducted to evaluate both pharmacological and non-pharmacological interventions. Ten studies involving 879 participants between the ages of three and 19 were included. The interventions reviewed encompassed psychological therapies, educational support programs, dietary supplements, and digital tools. Several interventions demonstrated notable improvements in emotional regulation, behavioral functioning, and family dynamics. The evidence consistently highlights the benefits of integrated, family-oriented approaches in enhancing cognitive and psychological outcomes in this population. Despite encouraging results, limitations such as small sample sizes, short follow-up periods, and variability in study designs indicate a need for further high-quality research. These findings emphasize the importance of incorporating mental health and cognitive support as essential elements of pediatric epilepsy care and call for greater efforts to develop standardized, accessible treatment models.