Abstracts

Approximately 30% of people with epilepsy (PWE) spontaneously report depressed mood as a significant problem having a negative effect on quality of life (QoL). Within the general population, over half of adults with depression also suffer from a diagnosable anxiety disorder. Increasingly, the literature suggests that PWE may also experience significant symptoms of anxiety. The Profile of Mood States (POMS) evaluates a wide number of mood states, including anxiety, and is useful for evaluating drug therapy interventions. The 31-item Quality of Life Inventory in Epilepsy (QOLIE-31) is a validated questionnaire which measures epilepsy-specific items such as seizure worry and broader items such as emotional well being and social functioning. Lamotrigine (LTG) is an antiepileptic drug (AED) that has been shown to improve mood, social interaction and overall wellbeing in PWE. This analysis investigated the correlation of anxiety with depression and quality of life in PWE and comorbid depressive symptoms, and changes following the addition of LTG to AED therapy., This was a multicenter open-label study. Lamotrigine was added onto a stable AED regimen in the adjunctive phase and became a single agent in the monotherapy phase. Patients were eligible if they had epilepsy, exhibited depressive symptoms [Center for Epidemiological Studies Depression Scale (CES-D) [ge] 12] but excluded if they had a Major Depressive Disorder as determined by a Mini International Neuropsychiatric Interview. Depression was measured with the Beck Depression Inventory (BDI-II); anxiety and quality of life were measured with the POMS anxiety domain and QOLIE-31 scale respectively. Evaluations were conducted at baseline, at the end of the adjunctive phase (Week 19) and the monotherapy phase (Week 36). Statistical analysis was done using paired t-tests and Spearman correlations., A total of 158 PWE (102 women, 56 men) enrolled into the study; 96 patients completed the adjunctive phase and 66 completed monotherapy. Mean baseline, end of adjunctive and monotherapy scores for BDI-II were 17.4, 11.6, and 7.7; for POMS anxiety, the scores were 14.9, 11.8 and 9.4; for QOLIE-31 the scores were 53.1, 64.8 and 72.3. POMS anxiety scores correlated with BDI-II at baseline (0.584) and with QOLIE-31 (-0.571); after adjunctive therapy, correlations were 0.618 and -0.591. With monotherapy, the correlations were 0.610 and -0.631. All change scores were significant at p [lt]0.001 and all correlations were significant at p [lt]0.0001., This evaluation suggests that anxiety is present in PWE who also exhibit depressive symptoms, and may contribute to low QoL scores reported in this population. The addition of LTG to the AED regimen significantly improved measures of both anxiety and depression with resulting improvement in quality of life., (Supported by GlaxoSmithKline Research and Development.)