Broadening the perspective: treating the whole patient.
Seizures are not the only obstacles that individuals with epilepsy must overcome. Treatment of epilepsy must take into consideration that patients with epilepsy often face some form of depression, such as peri-ictal depression, ictal depression, interictal depression, or postictal depression, as well as an elevated risk of suicide. Elderly patients, in particular, require special consideration, since aging affects pharmacokinetics and pharmacodynamics; women of childbearing age also require additional counseling. Treatment strategies that focus only on seizure reduction are inadequate and unsuccessful in up to one half of all patients with epilepsy. Epilepsy requires broad treatment strategies that address the needs of the whole patient. Age, genetic factors, gender, diet, use of alcohol and nicotine, comorbidities, and polypharmacy all are important factors to consider in determining a successful epilepsy treatment strategy. Epilepsy affects many aspects of psychosocial function, and optimal outcomes require that the needs of the whole patient be adequately addressed.
Krämer
Günter
G
Swiss Epilepsy Centre, Bleulerstrasse 60, CH-8008 Zurich, Switzerland. g.kraemer@swissepi.ch
D000014:Abnormalities, Drug-Induced / Q000209:etiology / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006694:Holistic Health; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012307:Risk Factors; D000092864:Suicide Prevention
D000927:Anticonvulsants