Depressive disorders in epilepsy and their treatment

Depressive disorders often remain unrecognized and untreated in patients with epilepsy, however the relatively high prevalence and the high incidence of suicides point towards the necessity for diagnosis and proper treatment. In epilepsy the clinical picture of depressive syndromes usually does not meet the ICD-10 or DSM-IV criteria of the affective disorders. The reported incidence for depressive disorders in epilepsy varies between 30-70%. Various causative factors such as seizure type, lateralization of seizure focus, dysfunctions in neuro-transmission as well as hereditary, psychosocial factors or negative psychotropic properties of antiepileptic drugs (AED), contribute to the pathogenesis. Despite the lack of controlled studies the administration of serotonergic antidepressants in the treatment of depressive disorders in epilepsy can be recommended.