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The Relationship Between Epilepsy and Depression

Summary & Participants

Many people with epilepsy also experience depression. What can you do?

Medically Reviewed On: January 14, 2008

Webcast Transcript

ANNOUNCER: Depression is a common occurrence among people with epilepsy. It has been estimated that one out of every three people with epilepsy will experience an episode of depression. This has prompted researchers to re-evaluate the link between epilepsy and depression.

ANDRES KANNER, MD: Up until fifteen or twenty years ago, it was assumed that the relationship between depression and epilepsy was of a unidirectional type. That is, people with epilepsy were more likely to have depression, and therefore epilepsy was a condition that precipitated or facilitated the development of a depressive disorder.

ANNOUNCER: That notion was challenged in the 1990s, when researchers found that people with epilepsy were more likely to have experienced depressive episodes before ever having had a seizure. That raised the question as to whether depression could be associated with an increased risk of developing epilepsy.

ANDRES KANNER, MD: We are seeing here that the relationship between depression and epilepsy goes both ways. What we are trying to say here is not that depression causes epilepsy or epilepsy causes depression, but maybe that the two disorders may share common mechanisms in what causes their disease that can result in the higher frequencies of the occurrence of the two conditions together.

ANNOUNCER: When depression is present in a patient, it can have significant impacts on the treatment of epilepsy.

ANDRES KANNER, MD: First of all, it may interfere with the ability of the patient to follow up his medication regimen as prescribed. It will be easier for the patient to forget to take his medication. There is now evidence that people with epilepsy and depression are often more likely to complain of adverse events from the medication.

There is also important economic impact on the lives of people with epilepsy, because the presence of depression has been associated with increased visits to the emergency room, to the physician's office, and that obviously increases the costs.

There is also new evidence, and this is still at a very early stage of research, that suggests that the presence of depression may be associated with a worse response to treatment of the seizure disorder. They're less likely to become seizure-free on pharmacologic treatment. And those people who had a prior history of depression appear not to be as likely to be seizure-free as those that did not have that kind of a history.

ANNOUNCER: Problems associated with depression can often persist because depression can go undiagnosed for years. Because physicians and neurologists are the first line of detection for depression, they need to be aware of its symptoms and actively screen for it.

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