Use of psychotropic drugs in patients with epilepsy: interactions and seizure risk.
It is now accepted that patients with epilepsy are more prone than the general population to develop psychiatric disorders, being significantly at risk due to psychosocial reasons, the presence of electrophysiologic and anatomopathologic abnormalities mainly in the limbic system, and because they are taking antiepileptic drugs which may have negative psychotropic effects. It is also known that many patients with epilepsy sometimes receive psychotropic medications on account of their psychiatric symptoms. This review focuses on the main problems that a clinician may encompass when treating psychiatric disorders in patients with epilepsy. On one hand, the effects of antiepileptic drugs on mood and behavior for a correct differential diagnosis of psychiatric symptoms. On the other hand, the main factors that may affect choice of therapy, patients' response and compliance, when prescribing antidepressants or antipsychotic drugs, drug interactions and the potential proconvulsive risk are reviewed.
Mula
Marco
M
Department of Neurology, Amedeo Avogadro University, C.so Mazzini, 18-28100 Novara, Italy. marcomula@yahoo.it
Monaco
Francesco
F
Trimble
Michael R
MR
D000927:Anticonvulsants / Q000493:pharmacokinetics / Q000627:therapeutic use; D004347:Drug Interactions; D004827:Epilepsy / Q000188:drug therapy* / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D009097:Multienzyme Complexes / Q000378:metabolism; D011619:Psychotropic Drugs / Q000493:pharmacokinetics / Q000627:therapeutic use*; D012306:Risk; D012640:Seizures / Q000188:drug therapy*
D000927:Anticonvulsants; D009097:Multienzyme Complexes; D011619:Psychotropic Drugs; D008094:Lithium