Diagnosis and management of depression and psychosis in children and adolescents with epilepsy

Andres M. Kanner, David Dunn

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

The neurologic dysfunction underlying epilepsy can predispose patients to psychiatric disorders, and the incidence of both depression and psychosis is increased in people with epilepsy. Depressive disorders are the most frequently recognized psychiatric comorbidities in people with epilepsy, but depression in children can be particularly difficult to recognize. Clinicians need to inquire about not only classic symptoms of depression such as anhedonia but also less obvious symptoms such as unprovoked irritability, unsubstantiated complaints of lack of love from family members, somatic complaints, and problems with concentration and poor school performance. The diagnosis of depressive disorders in children with epilepsy and mental retardation is even more difficult. Physicians need to be alert for the presence of iatrogenic depression, which may result from antiepileptic drugs or epilepsy surgery. People with epilepsy are also at increased risk for psychosis, which can be interictal, postictal, or (rarely) an expression of ictal activity. This psychosis can be related to seizure remission (ie, alternative psychosis) or iatrogenic (eg, related to antiepileptic drugs or following temporal lobectomy). Although both antidepressants and antipsychotic drugs have the potential to lower the seizure threshold and increase seizures, careful drug selection, dosing, and slow titration can minimize this risk, allowing treatment to proceed.

Original languageEnglish
JournalJournal of Child Neurology
Volume19
Issue numberSUPPL. 1
StatePublished - Aug 2004

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Psychotic Disorders
Epilepsy
Depression
Seizures
Depressive Disorder
Anticonvulsants
Psychiatry
Anhedonia
Love
Neurologic Manifestations
Intellectual Disability
Antidepressive Agents
Antipsychotic Agents
Comorbidity
Stroke
Physicians
Incidence
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health

Cite this

Diagnosis and management of depression and psychosis in children and adolescents with epilepsy. / Kanner, Andres M.; Dunn, David.

In: Journal of Child Neurology, Vol. 19, No. SUPPL. 1, 08.2004.

Research output: Contribution to journalArticle

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