Psychiatric Aspects of Epilepsy

  • Surabhi Sharma Junior Resident, Department of Psychiatry and Drug De-Addiction, Lady Hardinge Medical College and SSK Hospital, New Delhi, India.
  • Prerak Kumar Senior Resident, Department of Psychiatry and De-Addiction, Lady Hardinge Medical College and SK Hospital, New Delhi.
  • Saloni Seth Junior Resident, Department of Psychiatry and Drug De-Addiction, Lady Hardinge Medical College and SSK Hospital, New Delhi, India.
  • Bhavuk Garg Assistant Professor, Department of Psychiatry and Drug De-Addiction, Lady Hardinge Medical College and SSK Hospital, New Delhi, India.
  • Nitin Raut Specialist, Department of Psychiatry and Drug De-Addiction, Lady Hardinge Medical College and SSK Hospital, New Delhi, India.
  • Prerna Kukreti Associate Professor, Department of Psychiatry and Drug De-Addiction, Lady Hardinge Medical College and SSK Hospital, New Delhi, India.
Keywords: Epilepsy, Psychiatric Comorbidities, Seizure Threshold, Newer Anticonvulsants


A seizure is defined as transient change in neurological functioning which is characterised by hypersynchronous discharges of neurons in the brain regions whereas epilepsy is defined as a syndrome consisting of various recurrent seizures and it is associated with the psychological and neuropathological effects. Early recognition and management of psychiatric disorders in patients with epilepsy is extremely important, because it improves the quality of life and aids in better seizure control. Newer antiepileptics with less interaction with psychotropics and less behavioural manifestations should be used for management of epilepsy; and psychotropics having low potential for lowering seizure threshold are generally preferred. A holistic approach to assess psychiatric comorbidity and judicious use of medicine can help in comprehensive patient care planning and reduced health burden.

How to cite this article:
Sharma S, Kumar P, Seth S, Garg B, Raut N, Kukreti P. Psychiatric Aspects of Epilepsy. J Adv Res Psychol Psychother 2020; 3(3&4): 15-20.



Linn K. ILAE Classification of Seizures Types and Epilepsies (2017). International Journal of Pediatrics

& Neonatal Care 2017; 3(1).

Hesdorffer D, Ishihara L, Mynepalli L, Webb D, Weil J, Hauser W. Epilepsy, suicidality, and psychiatric disorders:

A bidirectional association. Annals of Neurology 2012; 72(2): 184-191.

Clancy M, Clarke M, Connor D, Cannon M, Cotter D. The prevalence of psychosis in epilepsy; a systematic

review and meta-analysis. BMC Psychiatry 2014; 14(1).

Kanner A. Anxiety Disorders in Epilepsy: The Forgotten Psychiatric Comorbidity. Epilepsy Currents 2011; 11(3):


Swinkels W, Kuyk J, Dyck R, Spinhoven P. Psychiatric comorbidity in epilepsy. Epilepsy & Behavior 2005;

(1): 37-50.

lper K, Schwartz KA, Kolts RL, Khan A. Seizure incidencein psychopharmacological clinical trials: an analysis of

Food and Drug Administration (FDA) summary basis of approval reports. Biol Psychiatry 2007; 62(4): 345-354.

Mohapatra S, Saha R, Kar S, Tekkalaki B, Anand K. Causative factors and phenomenology of depression

in epilepsy-A review. International Journal of Epilepsy 2017; 4(01): 070-078.

Ettinger AB, Reed ML, Goldberg JF, Hirschfeld RM: Prevalence of bipolar symptoms in epilepsy vs other

chronic health disorders. Neurology 2005; 65: 535-540.

Brandt C, Schoendienst M, Trentowska M et al. Prevalence of anxiety disorders in patients with

refractory focal epilepsy: a prospective clinic-based survey. Epilepsy Behav 2010; 17: 259-263

Swinkels W, Duijsens I, Spinhoven P. Personality disorder traits in patients with epilepsy. Seizure 2003; 12(8):


Blumer D, Montouris G, Davies K et al. 2002. Suicide in epilepsy: Psychopathology, pathogenesis and

prevention. Epilepsy Behav 3: 232-41.

Friedman D, Honig LS, Scarmeas N. Seizures and epilepsy in Alzheimer’s disease. CNS neuroscience &

therapeutics 2012; 18(4): 285-294.

Kaplan PW. Epilepsy and obsessive-compulsive disorder. Dialogues in clinical neuroscience 2010; 12(2): 241.

Hermann B, Jones J, Dabbs K, Allen CA, Sheth R, Fine J, McMillan A, Seidenberg M. The frequency,

complications and aetiology of ADHD in new onset paediatric epilepsy. Brain 2007; 130(12): 3135-48.

Piperidou C, Karlovasitou A, Triantafyllou N, et al. Influence of sleep disturbance on quality of life of

patients with epilepsy. Seizure 2008;17(7): 588-594.

Turaga S, Soanpet P, Manikinda J, Kohat AK, Davidi SR. Observational study of prevalence of sleep disorder in

patients with epilepsy. Int J Epilepsy 2016; 3: 20-23.

Moser D, Pablik E, Aull-Watschinger S, Pataraia E, Wöber CH, Seidel S. Depressive symptoms predict the

quality of sleep in patients with partial epilepsy - a combined retrospective and prospective study. Epilepsy

Behav 2015; 47: 104-110.

Babu C, Satishchandra P, Sinha S, Subbakrishna D. Comorbidities in people living with epilepsy: Hospital

based case–control study from a resource-poor setting. Epilepsy Research 2009; 86(2-3): 146-152.

Marsh L, Rao V. Psychiatric complications in patients with epilepsy: a review. Epilepsy Research 2002; 49(1):


Logsdail S, Toone B. Post-ictal psychosis: a clinical and phenomenological description. Br J Psychiatry 1988;

: 246-252.

Tellenbach H. Epilepsy as a convulsive disorder and as a psychosis. On alternative psychoses of paranoid

nature in” forced normalization” (Landolt) of the electroencephalogram of epileptics. Der Nervenarzt

; 36: 190-202.

Pollock DC. Models for understanding the antagonism between seizures and psychosis. Prog

Neuropsychopharmacol Biologic Psychiatry 1987; 11(4): 483-504.

Wolf P, Trimble MR. Biological antagonism and epileptic psychosis. Br J Psychiatry 1985; 146: 272–276.

Gobbi G, Giovannini S, Boni A, et al. Catatonic psychosis related to forced normalization in a girl with Dravet’s

syndrome. Epileptic Disord 2008; 10(4): 325-329.

Hedges D, Jeppson K, Whitehead P. Antipsychotic medication and seizures: a review. Drugs Today (Barc)

; 39(7): 551-7.

Adachi N, Kanemoto K, de Toffol B et al. Basic treatment principles for psychotic disorders in patients with

epilepsy. Epilpesia 2013; 54(Suppl 1): 19-33.

Mula M, Monaco F. Antiepileptic drugs and psychopathology of epilepsy: an update. Epileptic

disord 2009; 11(1): 1-9.

Chiron C, Marchand MC, Tran A, Rey E, d’Athis P, Vincent J et al. Stiripentol in severe myoclonic epilepsy in

infancy: a randomised placebo-controlled syndrome dedicated trial. STICLO study group. Lancet 2000; 356:


Porter RJ, Burdette DE, Gil-Nagel A, Hall ST, White R, Shaikh S, et al. Retigabine as adjunctive therapy in

adults with partial-onset seizures: integrated analysis of three pivotal controlled trials. Epilepsy Res 2012;

: 103-12.

Kerrigan JF, Shields WD, Nelson TY, Bluestone DL, Dodson WE, Bourgeois BF et al. Ganaxolone for treating

intractable infantile spasms: a multicenter, open-label, addon trial. Epilepsy Res 2000; 42: 133-139.

Stephen LJ, Brodie MJ. Pharmacotherapy of epilepsy: newly approved and developmental agents. CNS Drugs

; 25: 89-107.