Abstracts

Rationale: Depression, anxiety, and other psychiatric disorders are common in epilepsy. Hence a significant number of epilepsy patients are on psychotropic medications. Some psychotropic medications affect seizure control and may change pharmaco-kinetics and -dynamics of antiepileptics. We aimed to study the prevalence of psychiatric diagnosis and psychotropic use among patients at a university tertiary epilepsy care center on the east coast. Methods: We reviewed charts of 401 patients. Antiepileptics (AEDs), associated psychiatric diagnoses, and psychotropic medications are extracted. The percentages of diagnoses for mood, anxiety, psychotic, and other psychiatric disorders were calculated. We also report percentages of anti-depressant/anti-anxiety, antipsychotic, hypnotic, and other psychotropic medication use among all 401 patients. Results: Out of 401 patients 152 (38%) had a diagnosis in one of the following disorder groups: Mood (122; 30%), anxiety (13; 3.2%), psychotic (7; 1.8%), and other psychiatric disorders (10; 2.5%). 137 (34%) patients were on at least one: Antidepressant/antianxiety (98; 24%), antipsychotic (32; 8%), hypnotic (3; 0.8%), or other psychotropic medication(4; 1%). Nine (2.2%) patients had two psychiatric diagnoses and 30 (7.5%) patients were on two psychotropics. Twentysix (6.5%) patients had a psychiatric diagnosis, but no psychotropics and 5 (1.3%) patients were on psychotropics without any psychiatric diagnosis. Conclusions: The concomitant use of psychotropic agents with antiepileptics is a common practice in treatment of epilepsy patients. Therefore clinicians need to be aware of possible serious interactions between AEDs and psychotropic agents. Another aspect of the results is that clinicians should consider psychiatric conditions and psychotropic medication use among epilepsy patients and seek psychiatric consultation in complicated cases. Studying the pharmacological and therapeutic relationship between antiepileptics (inducers vs. inhibitors) and psychotropics are beyond the scope of this study, but could be a focus of future research.