December 12, 2005

Depression often remits after epilepsy surgery

NEW YORK (Reuters Health) - In patients with epilepsy that
does not respond to drug therapy, and who also have depression
or anxiety, surgery to treat the epilepsy often results in
improvements in psychiatric symptoms, according to results of a
multicenter study.

Depression and anxiety are common among patients with
epilepsy, Dr. Orrin Devinsky, from the New York University
School of Medicine, and his co-investigators note in the
journal Neurology. They followed 360 patients after they had
undergone epilepsy surgery to see if these conditions resolved.

Before surgery, 22.1 percent of the patients had depressive
symptoms and 24.7 percent had anxiety symptoms. These rates
declined to 11.7 percent and 13.0 percent, respectively, 24
months after surgery.

The results were somewhat related to surgical outcomes,
with approximately 18 percent of those who continued to
experience seizures reporting moderate to severe levels of
depression, versus 8 percent among those who were seizure-free.

There was no relationship between psychiatric symptoms and
location of the surgery.

The reasons why ongoing seizures increase the risk
continued depression after surgery remain unclear, Devinsky's
team notes. However, they suggest that it may involve
psychological factors, such as disappointment about
postoperative seizures and fear of seizures; the direct effects
of seizures; or increased levels of antiepileptic medication.

The researchers advise that before epilepsy surgery
patients should be informed that symptoms of depression and
anxiety improve for most patients.

SOURCE: Neurology, December 2005.