1. Recognize and treat depression in epilepsy Maryam PoursadeghFard Shiraz University of Medical Science
(1)Introduction: Depression is a major problem in epileptic patients for both recognition and treatment. Quality of life is highly influenced by depression than the seizure itself and mood status was the strongest aspect of health assessment in epileptic patients, then it is important to carefully recognize and treat it with appropriate antidepressant drugs.
(2)Method: we review literature and discuss about importance and safety of treatment in depressed epileptic patients with new antidepressant medications without significant drug interaction or increasing frequency.
(3)Result: when depression is properly treated, sleep and compliance with medications will be better and it enhances control of seizure. With regard to previous data, when dose of antidepressant drugs especially traditional (Clomipramine, Bupropion) is increased, the risk of seizure is provocated, however the risk of drug induce seizure is generally overestimated because most reports of seizure are from over dosage or patients without epilepsy and there are few data for increasing in seizure in epileptic patients received antidepressant in therapeutic range.
Recent reports have showed new antidepressant SSRIs or SNRIs have few side effects and little risk for seizure, thus at present they are recommended as first line medication for depression in epilepsy.
From SSRIs, sertraline is less likely to interact with antiepileptic drugs and then is preferred as a first choice. Citalopram also can be an alternative with minimal side effects.
(4)Conclusion: New antidepressant medications are not only safe to increase seizure frequency, but also protective in refractory cases with minimal drug interactions.