title: Treatment of interictal psychiatric disorder in epilepsy. I. Affective and anxiety disorders.
abstract: BACKGROUND
  Interictal affective disorders are common in patients with epilepsy and there is a need for evidence-based treatment guidelines.
  
  
  OBJECTIVE
  This paper gives an overview of research concerning treatment of interictal affective disorders and interictal anxiety disorders in epilepsy.
  
  
  METHODS
  Literature review supplemented by clinical experience.
  
  
  RESULTS
  Interictal psychiatric disorder can be characterized as intermittent pleomorphic psychopathology. The most common manifestations are interictal dysphoric disorder (IDD) and depression. There is a lack of randomized control trials (RCTs) concerning effectiveness and side-effects of antidepressants in epilepsy patients.
  
  
  CONCLUSIONS
  Treatment implications of the concept of IDD and other interictal disorders are an optimized dosage of anti-epileptics in combination with antidepressants. This coincides with recent guidelines concerning combinations of psychotropic medication, such as for depression and bipolar disorder, in general psychiatry. Systematic research involving the DSM-IV categories of generalized anxiety disorder, panic disorder and agoraphobia and depression is not yet available. Prevalence and treatment of interictal anxiety disorders and depressive disorder in epilepsy should be the subject of further research, in order to enable development of evidence-based treatment guidelines for these disorders in epilepsy patients.
authors.affiliation: 1Department of Psychiatry, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
authors.forename: Cm
authors.initials: C
authors.lastname: van der Feltz-Cornelis