Somatic comorbidity in Polish patients with epilepsy

Bosak, Magdalena; Kowalik, Monika; Mołek, Patrycja; Słowik, Agnieszka

doi:10.20452/pamw.14794

Cited by 2 publications

(3 citation statements)

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“…This explains why 172 patients with structural etiology, 7 with infections, and 5 patients with metabolic etiology were assigned to the group without comorbidities. Under‐reporting can also explain the differences in the prevalence of comorbidities between us and others 25–30 . However, in contrast with us, those studies were performed only in adults, with cross‐sectional designs, and investigated comorbidities through claims databases or telephone interviews.…”

Section: Discussionmentioning

confidence: 90%

“…Under-reporting can also explain the differences in the prevalence of comorbidities between us and others. [25][26][27][28][29][30] However, in contrast with us, those studies were performed only in adults, with cross-sectional designs, and investigated comorbidities through claims databases or telephone interviews. A second limitation is the lack of a population base.…”

Section: Discussionmentioning

confidence: 99%

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Comorbidities in patients with epilepsy: Frequency, mechanisms and effects on long‐term outcome

et al. 2021

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To assess frequency, types, and mechanisms of comorbidities in people with epilepsy and verify their association with disease features and outcome. Methods: This cohort study was performed in 13 Italian epilepsy centers with nationwide distribution and accurate records. Eligible patients were children and adults diagnosed before December 31, 2005, and followed for a minimum of 10 years. Two pairs of raters independently reviewed patients' records and classified each comorbidity. In case of disagreement, a third reviewer made the final decision. Comorbidities were classified according to type (organ/system) and underlying mechanism (causal, shared risk factors, chance association). Comorbidity types and mechanisms were described in the entire sample and according to epilepsy prognostic patterns (sustained remission, relapsing-remitting course, no remission). Results: Of 1006 included patients, 266 (26.4%) had at least one comorbidity. The most common were developmental/perinatal (7.5% of cases), psychiatric (6.2%), cardiovascular (5.3%), and endocrine/metabolic (3.8%). Among 408 reported comorbidities, the underlying mechanisms were, in decreasing order, chance association (42.2%), shared risk factors (31.1%), and causal (26.7%). Psychiatric diseases were present in 13.3% of patients with no remission, 5.9% of patients with relapsingremitting course, and 4.8% of patients with sustained remission (p = .016). The corresponding numbers for endocrine/metabolic diseases were respectively, 9.6%, 3.4%, and 2.9% (p = .013); for respiratory diseases were 3.6%, .3%, and .3% (p = .001), and for urogenital diseases were 3.6%, .7%, and 1.6% (p = .048). The association of endocrine/metabolic, psychiatric, and respiratory comorbidities with epilepsy prognosis was confirmed by multivariable analysis adjusted for the main demographic and

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Comorbidities in patients with epilepsy: Frequency, mechanisms and effects on long‐term outcome

et al. 2021

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“…To the best of our knowledge, only one case of a 52-year-old female patient with secondary epilepsy and depressive symptoms has been presented—the authors reported excellent response to vortioxetine (in dose of 20 mg daily) and, interestingly, reduction of visual scotomas after initiation of antidepressant treatment ( Onder et al, 2018 ). As patients with epilepsy often suffer from somatic and psychiatric comorbidities and thus may frequently require polytherapy, vortioxetine as a relatively safe, well-tolerated antidepressant with low risk of inducing pharmacokinetic interactions seems to be a valid treatment option in this group of patients ( Baldwin et al, 2016a ; Bosak et al, 2019 ). Besides, patients with epilepsy commonly suffer from cognitive impairment and it would be interesting to find out whether cognition enhancing properties of vortioxetine may additionally improve effects of treatment with this medication ( Holmes, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Vortioxetine in the Treatment of Depressive Symptoms in Patients With Epilepsy—Case Series

et al. 2022

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Epilepsy and depression are both serious and potentially disabling conditions which often coexist—bidirectional relationship between the two disorders has been observed. Comorbidity between depression and epilepsy can be attributed to: underlying common pathophysiological mechanisms, psychiatric side effect of antiepileptic medications and psychological response to stress in people with chronic, neurological condition. Despite high prevalence of depressive symptoms in patients with epilepsy, current evidence of the effectiveness of antidepressant therapy in this group of patients is very limited. Vortioxetine is an antidepressant with multimodal activity, very good treatment tolerability, low risk of inducing pharmacokinetic interactions, relative safety of treatment in patients with somatic comorbidities, low risk of causing: sedation, sexual dysfunctions and metabolic side effects. Vortioxetine seems to be a promising treatment option for depressed patients with cognitive dysfunctions, anhedonia and anxiety. In this case series, we report nine cases of patients with epilepsy and depressive symptoms treated with vortioxetine. Seven cases are patients with secondary focal and generalized epilepsy and two with unclassified epilepsy. Three patients presented with depressive episode in the course of bipolar disorder and six patients had depressive symptoms due to organic mood disorder. The dose range of vortioxetine was between 10 and 20 mg. In all of the presented cases effectiveness and tolerability of treatment were very good. Remission of depressive symptoms was achieved in all patients. No epilepsy seizures after switch to vortioxetine were observed in seven cases. In two patients seizures occurred during the first months of vortioxetine treatment but this most probably was due to suboptimal antiepileptic treatment—satisfactory seizure control was achieved after optimization of antiepileptic pharmacotherapy. Vortioxetine was discontinued in two of the presented cases due to pregnancy planning. The duration of observation period during vortioxetine therapy ranged from 2 to 48 months. In conclusion, vortioxetine can be a promising treatment option in patients with epilepsy and comorbid depressive symptoms.

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Somatic comorbidity in Polish patients with epilepsy

Cited by 2 publications

References 10 publications

Comorbidities in patients with epilepsy: Frequency, mechanisms and effects on long‐term outcome

Comorbidities in patients with epilepsy: Frequency, mechanisms and effects on long‐term outcome

Case Report: Vortioxetine in the Treatment of Depressive Symptoms in Patients With Epilepsy—Case Series

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