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Treatment issues for psychiatric comorbidities of epilepsy

Marco Mula

 Although frequently encountered in epilepsy, psychiatric comorbidities are
still underdiagnosed and undertreated. This is related to the lack of standardized treatment
approaches and the limited knowledge of neurologists on the treatment of psychiatric
disorders. More recently, international panels have published consensus documents in order to
favor a homogenous approach to the problem. This article discusses treatment issues of major
psychiatric comorbidities of epilepsy, namely mood and anxiety disorders and psychoses.
Moreover, specific problems in intellectually disabled patients are presented. In general terms,
new psychotropic medications, both antidepressant and antipsychotic drugs, are preferred
in terms of safety and efficacy. Careful attention to special needs of the patient, to drug–drug
interactions and the adoption of individualized titration schedules represent important variables.

 

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