Interventions for psychotic symptoms concomitant with epilepsy

Farooq, Saeed; Sherin, Akhtar

doi:10.1002/14651858.cd006118.pub3

Cited by 15 publications

(9 citation statements)

References 39 publications

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“…Regarding antipsychotics, the evidence is also scant. A Cochrane Review 51 quotes only a single controlled study investigating olanzapine (10 mg/day) as compared to haloperidol (12 mg/day) in 16 people with epilepsy and psychosis. This was, however, a conference abstract published 15 years ago and the study was never published.…”

Section: Pharmacological Treatmentsmentioning

confidence: 99%

Psychiatric Comorbidities in People With Epilepsy

et al. 2021

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Purposeof review: To review the latest evidence concerning the epidemiology, clinical implications and management of psychiatric disorders in epilepsy.Recent findings:People with epilepsy have a 2 to 5 times increased risk of developing any psychiatric disorder and 1 in 3 patients with epilepsy have a lifetime psychiatric diagnosis. Psychiatric comorbidities represent a poor prognostic marker as they have been associated with a poor response to treatment (drugs and surgery), increased morbidity and mortality. Validated screening instruments are available for mood and anxiety disorders in adults as well as attention deficit hyperactivity disorder in children with epilepsy.Summary:All patients with epilepsy should be routinely screened for psychiatric disorder at the onset and at least once a year. Patients with epilepsy and their relatives should be informed of the risk of mental health problems and the implications.

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Section: Pharmacological Treatmentsmentioning

confidence: 99%

Psychiatric Comorbidities in People With Epilepsy

et al. 2021

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“…Evidence for the treatment of IIP is limited, as evidenced by a recent Cochrane systematic review [52], which found only one small randomized controlled trial with insufficient power. Expert opinion is that antipsychotics and benzodiazepines are the treatment of choice for brief IIP [2].…”

Section: Pharmacotherapy For Brief and Chronic Interictal Psychosis (Iip)mentioning

confidence: 99%

Pharmacotherapy in patients with epilepsy and psychosis

Toffol

Trimble

Hesdorffer

et al. 2018

Epilepsy & Behavior

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The recognition and treatment of psychosis in persons with epilepsy (PWE) is recommended with the apparent dilemma between treating psychosis and opening the possibility of exacerbating seizures. The pooled prevalence estimate of psychosis in PWE is 5.6%. It has been proposed that a 'two hit' model, requiring both aberrant limbic activity and impaired frontal control, may account for the wide range of clinical phenotypes. The role of antiepileptic drugs in psychosis in PWE remains unclear. Alternating psychosis, the clinical phenomenon of a reciprocal relationship between psychosis and seizures, is unlikely to be an exclusively antiepileptic drug-specific phenomenon but rather, linked to the neurobiological mechanisms underlying seizure control. Reevaluation of antiepileptic treatment, including the agent/s being used and degree of epileptic seizure control is recommended. The authors found very few controlled studies to inform evidence-based treatment of psychosis in PWE. However, antipsychotics and benzodiazepines are recommended as the symptomatic clinical treatments of choice for postictal and brief interictal psychoses. The general principle of early symptomatic treatment of psychotic symptoms applies in epilepsy-related psychoses, as for primary psychotic disorders. In the authors' experience, low doses of antipsychotic medications do not significantly increase clinical risk of seizures in PWE being concurrently treated with an efficacious antiepileptic regimen.

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“…It has been shown that low starting doses and slow titration can be helpful in maximizing the therapeutic potential and reducing the risk of adverse effects. A recently published systematic literature review showed positive results for the use of antidepressants (Maguire et al, 2014) and inconclusive results for the use of antipsychotics (Farooq and Sherin, 2008) in patients with epilepsy. The choice of psychotropic medication in patients with epilepsy requires careful consideration, taking into account the effects of antidepressants and antipsychotics on seizure threshold, as well as their interaction potential with anticonvulsants.…”

Section: Mental Healthmentioning

confidence: 99%

Women with epilepsy: clinically relevant issues

Bangar¹,

Shastri²,

El‐Sayeh³

et al. 2016

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SummaryWomen with epilepsy (WWE) face specific challenges throughout their lifespan due to the effects of seizures and antiepileptic drugs on hormonal function, potentially affecting both sexual and reproductive health. This review article addresses the most common issues of practical relevance to clinicians treating WWE: epidemiology and clinical presentations (including catamenial epilepsy), contraception, reproductive and sexual dysfunction, pregnancy, lactation, menopause-related issues (including bone health), and mental health aspects. Awareness of these gender-specific issues and implementation/adaptation of effective interventions for WWE results in significantly improved health-related quality of life in this patient population.

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Interventions for psychotic symptoms concomitant with epilepsy

Cited by 15 publications

References 39 publications

Psychiatric Comorbidities in People With Epilepsy

Psychiatric Comorbidities in People With Epilepsy

Pharmacotherapy in patients with epilepsy and psychosis

Women with epilepsy: clinically relevant issues

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