| SPECIAL ARTICLE |
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| Year : 2019 | Volume
: 7
| Issue : 1 | Page : 104-111 |
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Epilepsy and depression: An update
Marco Mula
Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
Correspondence Address:
Dr. Marco Mula
Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, London SW17 0QT
United Kingdom
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/amhs.amhs_54_19
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Depression is one of the most frequent comorbidities in patients with epilepsy affecting 1 in 4 patients, and this is due to psychological and neurobiological reasons. This is a narrative review of the epidemiological, neurobiological, and clinical aspects of depression in epilepsy. References have been identified through Medline/PubMed searches till February 2019 using the terms “epilepsy” AND “depression”. Additional articles were identified from the author's own files and from chosen bibliographies. Epilepsy and depression have a complex bidirectional relationship suggesting shared neurobiological mechanisms and the possibility that depression is a premorbid symptom of some epilepsy syndromes. The phenomenology of depression can be different from that seen outside epilepsy, but epilepsy-specific screening instruments, such as the Neurological Disorders Depression Inventory for Epilepsy, are now available to be used in routine clinical practice. Sertraline and citalopram can be considered first-line treatment in moderate to severe depression while psychological treatments should always be offered to mild to moderate cases.
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