Psychiatric Comorbidities in Epilepsy Management and Dynamics
Summary
Epilepsy is frequently accompanied by psychiatric comorbidities—such as depression, anxiety and psychosis—which significantly influence clinical outcomes, quality of life and healthcare utilisation. These comorbidities arise through multifaceted mechanisms, including shared neurobiological substrates, adverse effects of antiepileptic medications and psychosocial stressors linked to seizure unpredictability. In particular, temporal lobe epilepsy exhibits a high burden of mood and behavioural disturbances, owing in part to hippocampal sclerosis and altered limbic circuitry. The bidirectional relationship implies that mood disorders may exacerbate seizure susceptibility through dysregulation of stress pathways, while recurrent seizures can precipitate or worsen psychiatric symptoms. Management of epilepsy hence demands integrated approaches that address both seizure control and mental health, such as routine screening with validated tools, careful selection of antiepileptic drugs to minimise mood destabilisation and the use of adjunctive psychological or pharmacological therapies. Global research efforts aim to elucidate mechanistic links, refine diagnostic instruments and develop targeted treatments that can attenuate both seizures and psychiatric symptoms without detrimental cross-effects.
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Psychiatric Comorbidities in Epilepsy Management and Dynamics publication trend
The graph below shows the total number of articles in psychiatric comorbidities in epilepsy management and dynamics across all publications each year (not limited to Nature Index journals).
Technical terms
Comorbidity: The simultaneous presence of two or more medical conditions in a patient.
Temporal lobe epilepsy (TLE): A form of focal epilepsy originating from the temporal lobes, often associated with hippocampal sclerosis and psychiatric symptoms.
Hippocampal sclerosis: Neuronal loss and scarring in the hippocampus, frequently observed in TLE and linked to memory and mood disturbances.
mTORC1: Mechanistic target of rapamycin complex 1, a kinase complex that regulates cell growth and synaptic plasticity.
Polytherapy: The use of two or more antiepileptic drugs concurrently, which can increase the risk of side effects including mood disorders.
References
- Pharmacological inhibition of S6K1 rescues synaptic deficits and attenuates seizures and depression in chronic epileptic rats. CNS Neuroscience & Therapeutics (2023).
- Temporal Lobe Epilepsy and Psychiatric Comorbidity. Frontiers in Neurology (2021).
- Depression among epileptic patients and its association with drug therapy in sub-Saharan Africa: A systematic review and meta-analysis. PLOS ONE (2019).
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