癫痫与抑郁

Epilepsy and depression

抑郁是癫痫最常见的共患精神障碍疾病之一,发病率大约在30%~35%之间。抑郁严重影响癫痫患者的生活质量、增加患者自杀风险,明显增加医疗负担。很多癫痫合并抑郁患者因为担心抗抑郁药物可增加癫痫恶化的风险,或者不知道选择哪种抗抑郁药物,而没有得到及时、正确的治疗。同样,有些抗癫痫药物同时具有治疗抑郁的作用,临床选择抗癫痫药物时,应该考虑到共患病抑郁的情况。本文对以上情况进行介绍供临床参考。

Depression is the most frequent comorbid psychiatric disorder in epilepsy, with lifetime prevalence rates ranging between 30% and 35%. Comorbid depression in epilepsyaffects negatively the health-related quality of life, increases suicide risk and costs of medical care when compared to patients without depression. There is concern that patients may not be receiving appropriate treatment for their depression because of uncertainty regarding which antidepressant or class works best and the perceived risk of exacerbating seizures. Though the antiepileptic drugs （AEDs） receive initial indications for the treatment of epilepsy, currently the majority of AEDs are used to treat psychiatric disorders. Thus in selecting the appropriate AEDs for treatment of patients with epilepsy （PWE）, consideration should be given to which AEDs best treat the epileptic disorder and the psychiatric comorbidity. This review aims to address these issues and inform clinical practice and future research.