Abstracts

Rationale: Though depression is common in persons with epilepsy, it often remains undiagnosed and/or untreated. The current study aims to determine the proportion of persons with epilepsy receiving depression-related treatment and to characterize the type of treatment received. Methods: Persons with epilepsy (n=185) from the only epilepsy clinic in a city of 1.2 million people completed questionnaires and a gold-standard structured clinical interview (SCID) to assess current and past depression. Treatment for depression (pharmacological and non-pharmacological) was ascertained through patient self-report and chart review. Results: Of those with current depression (n=27), the majority (70.3%) were not on any depression-related treatment. In persons with current depression, non-pharmacological management was the most common treatment method, followed by treatment with psychotropic medications such as selective serotonin reuptake inhibitors (SSRIs). More individuals with a past history of depression but without a current episode (n=43) were treated (37.2%); it was more common for these individuals to be treated with pharmacological measures. The most commonly used medications in persons being treated for depression were SSRIs and most individuals reported receiving non-pharmacological treatment from their family doctor. After using an algorithm that adjusts the treated prevalence for those who are successfully treated, the adjusted proportion of depression treatment was 53.1%. Conclusions: Despite the high prevalence of depression in persons with epilepsy, most currently depressed individuals remain untreated. Most persons with epilepsy with current depression were receiving non-pharmacological treatment, whereas most people receiving treatment for past depression were on pharmacological therapies. Future studies should investigate barriers to treatment and how depression treatment can be optimized for those with epilepsy.