Epilepsy and paroxysmal conditions

Advanced search



The prevalence of depression (D) in patients with epilepsy (PE) is quite high and 12-37% due to common neurobiological structural and morphological  and neurotransmitter  mechanisms underlying  these  diseases.  Depression  negatively affects the quality of life and control of seizures  in PE is associated  with a high risk of suicidality in PE, the disease is poorly diagnosed  the PE shall be appointed and rarely antidepressants  (AD) for the treatment  D in PE.

Materials  and Methods. The aim of our prospective observational study with an active control was to evaluate the clinical efficacy and safety  of AD the second  generation – of escitalopram in the treatment  of depressive  disorders in 30 PE with D. The control group consisted  of 30 PE not receiving AD. Evaluation of the effectiveness of treatment in PE with D was carried out at three points (baseline, after 3 and 6 months  of treatment  AD) by depression  rating score using psychometric scales and scales assessing the overall clinical impression  of the gravity of the violations.

Results.  In the PED group, treated with AD significantly decreased the values of D, there was a decrease in the severity and frequency of seizures, improvement  in the overall clinical impression,  while distinct trends in these indicators in the comparative group were note.

Conclusion. Our findings confirm the need for early detection  of D in PE and destination AD with a harmonious profile of efficacy and safety.

About the Authors

L. V. Lipatova
St. Petersburg V. M. Bekhterev Psychoneurological Research Institute
Russian Federation

Lipatova Lyudmila Valentinovna – MD, PhD, Principal Researcher,  Head of the Department  of treatment  of patients  with organic  mental  disorders  and  epilepsy.

Ul. Bekhtereva, 3, St. Petersburg, Russia, 192019. Tel.: +7(812)4127280.  e-mail:

B. G. Butoma
St. Petersburg V. M. Bekhterev Psychoneurological Research Institute
Russian Federation

Butoma Boris Georgievitch – MD, PhD, leading researcher of the department  of the psychosocial  rehabilitation of psychiatric patients.

Ul. Bekhtereva,  3, St. Petersburg, Russia, 192019. Tel.: +7(812)4127280.  e-mail:

T. V. Kapustina
St. Petersburg V. M. Bekhterev Psychoneurological Research Institute
Russian Federation

Kapustina Tatiana Vladimirovna – MD, researcher of the Department of treatment  of patients with organic mental disorders and epilepsy.

Ul. Bekhtereva, 3, St. Petersburg, Russia, 192019. Tel.: +7(812)4127280.


1. Burd S. G., Rider F. K., Badalyan O. L., Avakyan G. G., Chukanova A. S. Russkii meditsinskii zhurnal. Nevrologiya. 2008; 16 (12): 1-5.

2. Vorob’eva O. V. Zh. Effektivnaya farmakoterapiya. 2013; 32: 38-44.

3. Kalinin V. V. Zh. Vestnik epileptologii. 2008; 1: 13-17.

4. Kotov A. S. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2014; 3: 58.

5. Lipatova L. V., Sivakova N. A. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2014; 6 (3): 59-60.

6. Blumer D., Altshuler L. L. Affective disorders. In: Engel J, Pedley A, eds. Epilepsy: a comprehensive textbook. Philadelphia. 1998; 2083-99.

7. Blumer D., Montouris G., Davies K. The interictal dysphoric disorder: recognition, pathogenesis, and treatment of the major psychiatric disorder of epilepsy. Epilepsy Behav. 2004; 5: 826-840.4.

8. Blumer D., Montouris G., Davies K. et al. Suicide in epilepsy: psychopathology, pathogenesis, and prevention. Epilepsy Behav. 2002; 3: 232-241.

9. Boylan L. S., Flint L.A, Labovitz D. L. et al. Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy. Neurology. 2004; 62: 258-261.

10. Brent D. A. Overrepresentation of epileptics in a consecutive series of suicide attempters seen at a children’s hospital, 1978-1983. J Am Acad Child Psychiatry. 1986; 25: 242-6.

11. Brent D. A., Crumrine P. K., Varma R. R. et al. Phenobarbital: treat treatment and major depressive disorder in children with epilepsy. Pediatrics. 1987; 80: 909-17.

12. Calabrese J. R., Bowden CL.., Sachs G. S., et al. A double blindplacebo-controlled study of lamotrigine monotherapy in outpatientswith bipolar I depression: Lamictal 602 Study group. J ClinPsychiatry. 1999; 60: 79-8.

13. Comai S., Tau M., Gobbi G. The psychopharmacology of aggressive behavior: a trans-lational approach part 1: neurobiology. J ClinPsychopharmacol. 2012; 32: 83-94.

14. Cramer J., Blum D., Fanning K., Reed M.; Epilepsy Impact Project Group. The impact of comorbid depression on health resource utilization in a community sample of people with epilepsy. Epilepsy Behav. 2004; 5: 337-342.

15. Dudra-Jastrzebska M. et al. Mood disorders in patients with epilepsy. Pharmacological reports. 2007; 59: 369-378.

16. El-Mallakh R.S., Huff M. O. Mood stabilizers and ion regulation. Harv Rev Psychiatry. 2001; 9: 23-32.

17. Ettinger A., Reed M., Cramer J. Depression and comorbidity in community-based patients with epilepsy or asthma. Neurology. 2004; 63: 1008-1014.

18. Favale E., Audenino D., Cocito L., Albano C. The anticonvulsant effect of citalopram as an indirect evidence of serotonergic impairment in human. Epileptogenesis Seizure. 2003; 12: 316-318.

19. Ferrie C. D., Robinson R. O., Panayiotopoulos C. P. Psychotic and severebehavioural re-actions with vigabatrin: a review. Acta Neurol Scand. 1996; 93: 1-8.

20. Galeotti N., Bartolini A., Ghelardini C., Blockade of intracellular calcium release in-duces an antidepressant-like effect in the mouse forced swimming test. Neuropharmacology. 2006 Mar; 50 (3): 309-16.

21. Gillian F. G., Barry J. J., Hermann B. P. et al. Rapid detection of major depression in epilepsy a multicenter study. Lancet Neurol. 2006; 5: 388-405.

22. Janssen-Cilag. Topamax. Product Monograph. 1996.

23. Kanner A. M., Kozak A. M., Frey M. The use of sertraline in patientswith epilepsy: is it safe? Epilepsy Behav. 2000; 1: 100-5.

24. Kanner A. M. Depression and Epilepsy: A New Perspective on Two Closely Related Disorders. EpilepsyCurrents. 2006; 6 (5): 141-146.

25. Kerr M. P., Mensah S., Besag F., Toffol B., Ettinger A., Kanemoto K., Kanner A., Kemp S., Krishnamoorthy E., Curt LaFrance Jr W., Mula M., Schmitz B., Tebartz van Elst L., Trollor J., Wilson S. J. International consensus clinical practice statements for the treatment of neuropsychiatric conditions associated with epilepsy. Epilepsia. 52 (11): 2133-2138, 2011.

26. Kessler R. C., Berglund P. A., Demler O., Jin R., Walters E. E. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R) under review.

27. Ketter T. A., Post R. M., Theodore W. H. Positive and negative psychiatric effects of an-tiepileptic drugs in patients with seizure disorders. Neurology. 1999; 53 (5, Suppl. 2): 53-67.

28. Kimiskidis Vasilios K. et al. Depression and anxiety in epilepsy: the association with demographic and seizure-related variables. Annals of General Psychiatry. 2007; 6: 28.

29. Kobau R., Gilliam F., Thurman D. J. Prevalence of selfreported epilepsy or seizure disorder and its associations with self-reported depression and anxiety: results from the 2004 Healthstyles Survey. Epilepsia. 2006; 47: 1915-1921.

30. Landolt H. Some clinical electroencephalographical correlations inepileptic psychoses (twilight states). Electroencephalogr Clin Neurophysiol. 1953; 5: 121.

31. Letterman L., Markowitz J. S. Gabapentin: a review of publishedexperience in the treatment of bipolar disorder and other psychiatricconditions. Pharmacotherapy. 1999; 99: 565-72.

32. Levinson D. F., Devinsky O. Psychiatric adverse events during vigabatrintherapy. Neurology. 1999; 53: 1503-11.

33. Marcotte D. Use of topiramate, a new antiepileptic as a mood stabilizer. J Affect Disord. 1998; 50: 245-51.

34. Mendez M. F., Cummings J. L., Benson D. F. Depression in epilepsy; significance and phenomenology. Arch Neurol. 1986; 43766-770.

35. Mohammadi M. R., Ghanizadeh. A, Davidian H., Mohammadi M., Norouzian M. Preva-lence of epilepsy and comorbidity of psychiatric disorders in Iran. Seizure. 2006; 15: 476-482.

36. Montgomery S. A., Asberg M. A. new depression scale designed to be sensitive to change. Br J Psychiatry. 1979; 134: 382-389.

37. Montgomery S. A. Antidepressants and seizures: emphasis on newer agents and clinical implications. Int J Clin Pract. 2005; 59: 1435-40.

38. Murray C. J., Lopez A. D. Global mortality, disability, and the contribution of risk factors: global burden of disease study. Lancet. 1997; 349: 1436-1442.

39. Noe K. H., Locke D. E. C., Sirven J. I. Treatment of Depression in Patients with Epilepsy. Current Treatment Options in Neurology. 2011; 13: 371-379.

40. Porter R. J., Dhir A., Macdonald R. L., Rogawski M. A. Mechanisms of action of anti-seizure drugs. Handb Clin Neurol. 2012; 108: 663-681.

41. Ramsey T. A., Frazer A., Mendels J. Plasma and erythrocyte cations in affective illness. Neuropsychobiology. 1979; 5: 1-10.

42. Reefhuis J., Devine O., Friedman J. M., Louik C., Honein M. A. Specific SSRIs and birth defects: bayesian analysis to interpret new data in the context of previous reports. BMJ. 2015; 351. DOI: http://dx.doi. org/10.1136/bmj.h3190 (Published 08 July 2015).

43. Robertson M. M., Trimble M. R. The treatment of depression in epilepsy:a double blind trial. J Affect Disord. 1985; 9: 127-36.

44. Robertson M. M., Trimble M. R., Townsend H. R.A. Phenomenology of depression in epilepsy. Epilepsia. 1987; 28: 364-72.

45. Schmitz B. Antidepressant Drugs: Indications and Guidelines for Use in Epilepsy. Epilepsia. 2002; 43 (2): 14-18.

46. Schmitz B. Psychiatrische Symptome bei Epilepsie: welschen Effekth aben Antiepileptika? Novo Nordisk Satelliten Symposium, Deutsche Ligagegen Epilepsie, Handout: Tiagabin: Einweiterer Schritt in der Kunstzuhelfen. 1996; 24-7.

47. Spina E., Santoro V., D’Arrigo C. Clinically Relevant Pharmacokinetic Drug Interactions with Second-Generation Antidepressants: An Update Clinical Therapeutics. 2008; 30 (7): 1206-47.

48. Spina E. et al. Clinically relevant pharmacokinetic drug interactions with second-generation antidepressants: an update. ClinTher. 2008 Jul; 30 (7): 1206-27. Flockhart, DA (2007). Drug Interactions: Cytochrome P450 Drug InteractionTable. Indiana Uni-versitySchool of Medicine. http://

49. Thomas L., Trimble M., Schmitz B., et al. Vigabatrin and behaviour disorders: a retrospective study. Epilepsy Res. 1996; 25: 21-7.

50. Torres S. J., Nowson C. A., Worsley A. Dietary electrolytes are related to mood. Br J Nutr. 2008; 100: 1038-1045.

51. Walden J., Normann C., Langosch J., et al. Differential treatment ofbipolar disorders with old and new antiepileptic drugs. Neuropsychobiology. 1998; 38: 181-4.

52. Yilmaz Z., Ceschi A., Rauber-Luthy C.H., Sauer O., Stedtler U., Prasa D., Seidel C., Hackl E., Hoffmann-Walbeck P., GerberZupan G., Bauer K., Kupfershmidt H., KullakUblick G.-A., Wilks M. Escitalopram causes fewer seizures in human overdose than citalopram.Clinical Toxicology. 2010; 48: 207-212.


For citations:

Lipatova L.V., Butoma B.G., Kapustina T.V. THE CHOICE OF ANTIDEPRESSANTS FOR THE TREATMENT OF DEPRESSIVE DISORDERS ASSOCIATED WITH EPILEPSY. Epilepsy and paroxysmal conditions. 2016;8(3):34-44. (In Russ.)

Views: 986

ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)