Treatments for patients with comorbid epilepsy and depression: A systematic literature review

Depression is recognized as a serious comorbidity of epilepsy, but treatment of depression and anxiety in people with epilepsy is challenging. The aim of this article was to review published controlled clinical treatment studies of depression and anxiety in patients with epilepsy. The PubMed, Cochrane and PsycINFO databases were searched for controlled clinical trials, or controlled psychosocial or behavioral trials published in English before June 2012. Search terms were: seizures, epilepsy, depression, psychotherapy, cognitive therapy/treatment, behavioral therapy/treatment and nonpharmacologic therapy/treatment, education and stress management. Seven studies were included in this review. Interventions included antidepressant medications, antiepileptic medications, and cognitive behavioral therapy. Despite the methodological limitations in the studies identified by this review, both medications and psychotherapy improved depression and anxiety in patients with epilepsy. However, further research is needed in the form of randomized controlled clinical trials to establish appropriate pharmacological and psychosocial co-management of depression and epilepsy.