title: The effects of lacosamide on depression and anxiety in patients with epilepsy.
abstract: Depression and anxiety are common in patients with epilepsy. Moreover, some antiepileptic drugs (AEDs) have mood stabilizing and anxiolytic effects, while others may worsen psychiatric symptoms. The effects of lacosamide, a third generation AED approved for the treatment of focal onset seizures, on depressive and anxiety symptoms are unknown. We evaluated changes in depression and anxiety following the initiation of lacosamide. We compared patients' scores on the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E, n = 91) and Generalized Anxiety Disorder 7-item (GAD-7, n = 20) scales prior to and following lacosamide treatment. Following the initiation of lacosamide, there were no significant changes in NDDI-E scores when all patients were analyzed aggregately (baseline: 12.14 ± 4.64 vs post-treatment: 11.91 ± 4.14, p = 0.51). Similarly, the mean GAD-7 scores at baseline (4.10 ± 4.52) and after treatment (4.75 ± 5.51) did not differ (p = 0.23). In the 25 patients with initial NDDI-E scores of >15, lacosamide was associated with a significant decrease in depressive symptoms (baseline: 17.60 ± 1.63 vs post-treatment: 14.64 ± 2.78, p < 0.001). NDDI-E and GAD-7 scores pre- and post-lacosamide initiation were not significantly affected by a history of mood disorders, concomitant psychiatric medications, or concomitant AEDs with mood-stabilizing effects.
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA. Electronic address: briandmoseley@gmail.com.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Moseley
authors.affiliation: School of Medicine, Case Western Reserve University, Cleveland, OH, USA. Electronic address: devlinkcole@gmail.com.
authors.forename: Devlin
authors.initials: D
authors.lastname: Cole
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA. Electronic address: oiwuora@gmail.com.
authors.forename: Ogonna
authors.initials: O
authors.lastname: Iwuora
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA. Electronic address: jeffrey.strawn@uc.edu.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Strawn
authors.affiliation: Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA. Electronic address: PRIVITMD@UCMAIL.UC.EDU.
authors.forename: Michael
authors.initials: M
authors.lastname: Privitera
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000150:complications* / Q000188:drug therapy; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D000078334:Lacosamide; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D055815:Young Adult
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D000928:Antidepressive Agents; D000078334:Lacosamide
keywords: Anxiety; Depression; GAD-7; Lacosamide; NDDI-E