Objectives: Although epilepsy is associated with a high rate of psychiatric comorbidity, clinicians may withhold treatment with psychotropic drugs for fear of worsening seizures. We have assessed the occurrence of psychiatric disorders in a cohort of epilepsy patients and used the results to discuss this important topic.
Material and methods: Based on a questionnaire we made a survey of psychiatric symptoms in 167 adult patients referred to a tertial epilepsy center. The mean age was 42 years, and 72% had active epilepsy.
Results: Forty three patients (26%) had a psychiatric disorder, and 22 patients (13%) used psychotropic drugs. The most frequent diagnoses were mood disorders and anxiety.
Conclusions: Compared with the general population, people with epilepsy have an increased risk of developing psychiatric disorders. Patients with uncontrolled seizures are most vulnerable. These disorders appear to be under-diagnosed and under-treated, and the fear that psychotropic drugs can cause seizure exacerbation is probably overstated.