Detection and treatment of comorbid depression in people with epilepsy


Radvilė Stankevičiūtė1, Karolina Kazlauskaitė1, Gintarė Aukselytė2

1Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania

2 Faculty of Medicine, Vilnius University, Vilnius, Lithuania


Background: Depression is one of the most common comorbidities in epilepsy patients. It contributes to lower quality of life, higher suicide and drug overdose risks. In spite of its importance for optimum management of people with epilepsy, major depression often goes underdiagnosed. One of the reasons may be the lack of an established clinical standard for depression screening. In regard to treatment, it is difficult to find a suitable antidepressant for patients who not only use antiepileptic drugs, but are also more prone to experience seizures as a side-effect than the general population. However, non-pharmacological treatment options for major depression can also be offered in such circumstances.

Aim: To select and analyse the newest data available on epilepsy with comorbid depression.

Method: The literature review was conducted using “PubMed‘‘ database, selecting publications on the subject of epidemiology, quality of life, diagnostics and treatment of epilepsy comorbid with depression.

Conclusions: Epilepsy and depression have a bilateral relationship making it a substantial comorbidity to diagnose and to treat. Early screening can be conducted with sufficient accuracy using Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Patient Health Questionnaire (PHQ-9) or Emotional Thermometer (ET7). In epileptic patients major depression can be safely and effectively treated with SSRI’s and SNRI’s. Moreover, cognitive behavioural therapy (CBT) should also be considered as a mean to improve the quality of life, which is significantly reduced in more than a half of people with epilepsy.

Keywords: depression, epilepsy, major depressive disorder, screening tools, antidepressants.