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Current Treatment Options in Neurology

Erschienen in:

01.12.2017 | Epilepsy (E Waterhouse, Section Editor)

Epilepsy and Psychiatric Comorbidities: Drug Selection

verfasst von: Marco Mula, MD, PhD

Erschienen in: Current Treatment Options in Neurology | Ausgabe 12/2017

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Abstract

Purpose of review The pharmacological treatment of patients with epilepsy and psychiatric comorbidities may sometimes represent a therapeutic challenge. This review is focused on the pharmacological management of patients with epilepsy and psychiatric problems in terms of rationalization of the antiepileptic drug (AED) treatment and the pharmacological management of the most clinically relevant psychiatric comorbidities, namely mood and anxiety disorders, psychoses, and attention deficit hyperactivity disorder (ADHD).

Recent findings Up to 8% of patients with drug-resistant epilepsy develop treatment-emergent psychiatric adverse events of AED regardless of the mechanism of action of the drug and this is usually related to an underlying predisposition given by the previous psychiatric history and the involvement of mesolimbic structures. Careful history taking, periodic screening for mood and anxiety disorders, low starting doses, and slow titration schedules can reduce the possibility of AED-related problems. A pragmatic checklist for the pharmacological management of patients with epilepsy and psychiatric disorders is presented.

Summary patients should be informed of potential behavioral effects of AEDs but no drugs should be excluded a priori. Any psychiatric comorbidity should be addressed in the appropriate setting and full remission and recovery should always represent the first goal of any therapeutic intervention. Neurologists should be aware of the side effects of major psychotropic drug classes in order to fully counsel their patients and other health professionals involved.

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Titel: Epilepsy and Psychiatric Comorbidities: Drug Selection
verfasst von: Marco Mula, MD, PhD
Publikationsdatum: 01.12.2017
Verlag: Springer US
Erschienen in: Current Treatment Options in Neurology / Ausgabe 12/2017
Print ISSN: 1092-8480
Elektronische ISSN: 1534-3138
DOI: https://doi.org/10.1007/s11940-017-0483-0

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