The effect of depression and side effects of antiepileptic drugs on injuries in patients with epilepsy

Özmen, Selen Gür; Mula, Marco; Agrawal, Niruj; Cock, Hannah R.; Lozsadi, D. A.; Oertzen, Tim J. von

doi:10.1111/ene.13346

Cited by 22 publications

(17 citation statements)

References 24 publications

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“…Contrary to this finding, the most frequently prescribed AED was VPA in Saudi Arabia, 12 CBZ in Bangladesh, 13 PHT in India 15 and levetiracetam in London, UK. 22 In general, newer AEDs (gabapentin, pregabalin, lamotrigine, levetiracetam, and topiramate) are extensively used in most western countries. 19 This might be due to cost of the drugs and their accessibility in resource limited settings.…”

Section: Discussionmentioning

confidence: 99%

<p>Antiepileptic Drug Treatment Outcomes and Seizure-Related Injuries Among Adult Patients with Epilepsy in a Tertiary Care Hospital in Ethiopia</p>

Nasir

Yifru

Engidawork

et al. 2020

PROM

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Objective: Anti-epileptic drugs (AEDs) are the primary therapeutic modalities for epilepsy management. However, one-third of epileptic patients continue to experience seizure even with appropriate AED use. Patients with epilepsy are at increased risk for seizure-related injury and they have higher incidences of home, street and work accidents. There is a paucity of data on AED use pattern and treatment outcomes among patients with epilepsy in the tertiary hospitals of Ethiopia. Therefore, the aim of this study was to assess AED use pattern, treatment outcome, and prevalence of seizure-related injury among patients with epilepsy in Tikur Anbessa specialized Hospital (TASH), Ethiopia. Patients and Methods: An institution-based cross-sectional study was carried out on 291 patients with epilepsy attending the neurology clinic of TASH. A semi-structured questionnaire and data abstraction format were used to collect data through patient interview and medical chart review. Binary logistic regression was utilized to identify the associated factors of treatment outcome. Results: About 172 (59%) of the patients were taking a single AED, in which phenobarbital, 195 (67%), and phenytoin, 97 (33.3%), were the most frequently prescribed AEDs as monotherapy and combination therapy. Headache, depressed mood and epigastric pain were frequently reported as adverse drug reactions. Seizure-related injury was reported among 78 (26.8%) patients and head injury 15 (5.2%), desntal injury 15 (5.2%), soft tissue injury 14 (4.8%) and burns 10 (3.4%) were the commonest. About two-thirds (191, 65.6%) of the study participants had uncontrolled seizure. Medication adherence and multiple AEDs were significantly associated with treatment outcome. Conclusion: All the study participants were put on old generation AEDs with phenobarbital being the most frequently used. About two-thirds of the patients had uncontrolled seizure and seizure-related injury is still a serious concern among patients with epilepsy.

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Section: Discussionmentioning

confidence: 99%

<p>Antiepileptic Drug Treatment Outcomes and Seizure-Related Injuries Among Adult Patients with Epilepsy in a Tertiary Care Hospital in Ethiopia</p>

Nasir

Yifru

Engidawork

et al. 2020

PROM

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“…It has been established long time ago that depression is a better indicator of quality of life than seizure frequency itself (36). It is now becoming evident that depression is also associated with poor response to the antiepileptic drug treatment (37,38), poor outcome after epilepsy surgery (39,40), increased seizure severity (41), increased risk of injury (42) and premature mortality (43). Future studies need to clarify whether early identification and prompt treatment of psychiatric comorbidities can have an impact on the prognosis of the epilepsy or whether they just represent indicators of poor prognosis.…”

Section: Psychiatric Comorbidities As a Poor Prognostic Marker In Adumentioning

confidence: 99%

Common psychiatric comorbidities in epilepsy: How big of a problem is it?

Salpekar

Mula

2019

Epilepsy & Behavior

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Psychiatric illness and epilepsy commonly co-occur in adults and in children and adolescents. Theories of comorbidity are complex, but recurring associations between the conditions suggest overlap that is more than simple co-occurrence. Common underlying pathophysiology may imply that epilepsy itself may constituently include psychiatric symptoms. Conditions such as depression or cognitive difficulties commonly occur and in some cases, are considered to be associated with specific epilepsy characteristics such as localization or seizure type. Regardless of etiologic attributions to psychiatric comorbidity, it is clear today that treatment for epilepsy needs to target psychiatric illness. In many cases, quality-of-life improvements depend more upon addressing psychiatric symptoms than seizures themselves.

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“…Finally, a number of studies are now pointing out that depression is a prognostic marker in epilepsy as it is associated not only with poor quality of life [16] but also with antiepileptic drug-resistance [17,18], increased seizure severity [19], increased side effects of antiepileptic drugs [20], increased risk of accident and injuries [21], poor outcome after epilepsy surgery [22] and increased mortality [23].…”

Section: Introductionmentioning

confidence: 99%

Developments in depression in epilepsy: screening, diagnosis, and treatment

Mula

2019

Expert Review of Neurotherapeutics

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Introduction: Depression is one of the most frequent comorbidities in epilepsy affecting between 17% and 22% of patients but it is still underdiagnosed and undertreated. Areas covered: This paper discusses recent advances about screening, diagnosis and treatment of depression in epilepsy taking into account the heterogeneity of clinical scenarios where depression can occur. Expert opinion: A number of screening instruments are now validated for adults with epilepsy and their psychometric properties are discussed but the NDDIE is the most practical and cost-effective. Challenges in diagnosing depression in epilepsy are discussed including reasons for the atypical features of mood disorders in epilepsy. Psychological treatments and/or SSRIs are indicated but the level of evidence is still low. Even if there is no reason to hypothesis that internationally accepted guidelines of treatment of depression outside epilepsy may not be valid, rigorous studies are needed in order to have proper outcome measures. Epilepsy centers should have well-defined care pathways for depression in order to provide access to mental health support when needed.

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The effect of depression and side effects of antiepileptic drugs on injuries in patients with epilepsy

Abstract: Antiepileptic drug treatment should be reviewed in patients reporting injuries in order to evaluate the potential contribution and burden of AED side effects.

Cited by 22 publications

References 24 publications

<p>Antiepileptic Drug Treatment Outcomes and Seizure-Related Injuries Among Adult Patients with Epilepsy in a Tertiary Care Hospital in Ethiopia</p>

<p>Antiepileptic Drug Treatment Outcomes and Seizure-Related Injuries Among Adult Patients with Epilepsy in a Tertiary Care Hospital in Ethiopia</p>

Common psychiatric comorbidities in epilepsy: How big of a problem is it?

Developments in depression in epilepsy: screening, diagnosis, and treatment

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