[Effects of antiepileptic drugs on mood of people with epilepsy].
This article deals with the effect of antiepileptic drugs on mood when applied in epileptic patients. The author points that depressive symptoms occur significantly more frequently in epilepsy and there are more common factor in the mechanism of action of the antiepileptic and antidepressive agents. The relevant literature is surprisingly poor. Primary and large analysis regarding affective disorders coexisting with epilepsy is still lacking. From this aspect some antiepileptic drugs have not been investigated at all. The consequences of the papers originates from indirect sources like adverse events profiles of the study drugs or from psychometric tests performed for avoiding exclusion criteria of psychological nature. On the other hand the paper deals also with the difficulties of such kind of investigations concerning the classification of depressive signs presenting with epilepsy, special considerations of inclusion of appropriate patients and particular limits of the measuring and follow-up of the observed effect. As the result of the detailed analysis of the literature the author recommends lamotrigine, carbamazepine and oxcarbazepine as first choice antiepileptic drug for epileptic patients suffering from depressive disorder, too. On the contrary, phenobarbital, topiramate and vigabatrin are able to worsen the affective symptoms. Aimed, randomized, controlled studies are necessary for recognizing the whole spectrum of psychotropic effects of antiepileptic drugs and for their successful and individually tailored application in patients in their comorbid states. Author calls the attention for the importance of the treatment of depressive states frequently occurring in epileptic patients. These symptoms modify patient compliance and are able to influence even the epileptic process itself.
Rajna
Péter
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Semmelweis Egyetem, Pszichiátriai és Pszichoterápiás Klinika, Budapest. rajna@psych.sote.hu
D000339:Affect / Q000187:drug effects*; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology*; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives; D006801:Humans; D000077213:Lamotrigine; D019964:Mood Disorders / Q000139:chemically induced*; D000078330:Oxcarbazepine; D010349:Patient Compliance; D010634:Phenobarbital / Q000009:adverse effects; D011594:Psychometrics; D000077236:Topiramate; D014227:Triazines / Q000627:therapeutic use; D020888:Vigabatrin / Q000009:adverse effects
D000927:Anticonvulsants; D000928:Antidepressive Agents; D014227:Triazines; D000077236:Topiramate; D005632:Fructose; D002220:Carbamazepine; D020888:Vigabatrin; D000077213:Lamotrigine; D000078330:Oxcarbazepine; D010634:Phenobarbital