Psychiatric comorbidity and quality of life in patients with epilepsy on anti-epileptic monotherapy and polytherapy

Abstract

Objective: The bio-psycho-social factors affecting the quality of life in patients with epilepsy can be numerous but are often overlooked. The behavioral side effects of anti-seizure medications can be one such potential factor. The aim of the study is to address the effect of the number of anti-seizure medications on the development of psychiatric comorbidity and quality of life in patients with adequate seizure control. Materials and Methods: The study recruited 100 participants with generalized tonic-clonic seizures from a tertiary care center in North India, who were seizure-free from the last 1 month. The study participants were divided into two groups based on whether they were on monotherapy or polytherapy. The two groups were matched for their socio-demographic and clinical profile. We assessed for psychiatric comorbidity in each group using Mini International Neuropsychiatric Interview. All the study participants were given Hindi translated version of quality of life in the epilepsy-31 questionnaire for objective assessment of the quality of life. Results: The patients receiving anti-epileptic polytherapy had significantly higher prevalence of psychiatric comorbidity than patients on monotherapy. Furthermore, the patients on polytherapy scored significantly less on the cognitive domain of quality of life as well as the overall quality of life domain in the epilepsy-31 questionnaire. Conclusion: The patients with epilepsy must be evaluated for psychiatric comorbidity and side effect profile of anti-seizure medications to improve the quality of life. This is particularly more important for patients who are on anti-epileptic polytherapy even if the seizure control is adequate.

Prevalence and associated factors of psychiatric comorbidities in epilepsy in the Casablanca–Settat region of Morocco: A cross‐sectional study

“… 63 The identification of antiseizure polytherapy combinations as a predictive factor for ADS is similar to the results found by Yadav et al. 64 This association could reflect the involvement of the severity and the chronicity of seizures in drug‐resistant epilepsies in the promotion of these psychiatric disorders. 65 …”

“…39 In addition to epilepsy itself, the physical and emotional burden of chronic conditions may negatively impact the mental health of PWE. 63 The identification of antiseizure polytherapy combinations as a predictive factor for ADS is similar to the results found by Yadav et al 64 This association could reflect the involvement of the severity and the chronicity of seizures in drugresistant epilepsies in the promotion of these psychiatric disorders. 65 Finally, the finding of the structural etiology of epilepsy as a predictive factor of ADS in our study is comparable to what has been noted in Greece 59 and confirms the implication of epileptogenic structural alteration in psychiatric pathology.…”

A Comparative Study between Mono Antiepileptic Therapy and Poly Antiepileptic Therapy regarding Quality of Life in Adolescents with Epilepsy

“…Another study found that polytherapy was associated with a higher risk of cognitive impairment and lower quality of life in children with epilepsy, compared to monotherapy (21).…”

Modulating the gut microbiota ameliorates spontaneous seizures and cognitive deficits in rats with kainic acid-induced status epilepticus by inhibiting inflammation and oxidative stress

“…Epilepsy is a highly prevalent neurological disease affecting millions of people worldwide (1). Patients with recurrent seizures usually have disorders in cognition, sleep, and neuropsychiatry, which result in a low quality-of-life (2)(3)(4). Despite various anti-seizure medications (ASMs) used in the clinical treatment of epilepsy, the seizures of 30% of patients cannot be well-controlled, leading to the development of refractory epilepsy (5).…”