Mood disorders in epilepsy.

Depression is a common psychiatric problem associated with epilepsy. Interictal depressive symptoms are more frequent and severe in epileptic patients than in subjects with comparable chronic neurologic diseases or physical handicaps. Epileptic depression was characterized as major or dysthymic: bipolar depression is rarely described. Several Authors are of opinion that interictal depression is more frequent in epileptics with temporal lobe foci and, in particular, with temporal left hemisphere lesions. The pathogenetic significance of depression in epileptics is unclear. Some suggest the hypothesis that depression represents behavioral effects of neurochemical responses to brain injury for asymmetrical hemispheric distribution of neural substrate for mood. We think that depression in epileptic patients does not represent a psychological reaction to a particular cognitive or physical impairment, but it is in some way related to the type of epilepsy. In addition, some antiepileptic drugs may have psychotropic effects: the most positive findings were associated with carbamazepine.