John Libbey Eurotext

Gériatrie et Psychologie Neuropsychiatrie du Vieillissement

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Psychiatric effects of antiepileptic drugs in adults Volume 16, issue 2, Juin 2018

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Authors
1 Service de neurologie, Hôpital Bicêtre, Assistance Publique des Hôpitaux de Paris, AP-HP, Le Kremlin-Bicêtre, Hôpital du Sud Francilien, Corbeil-Essonnes, France
2 Service de neurophysiologie clinique et d’épileptologie, Hôpital Bicêtre, Assistance Publique des Hôpitaux de Paris, AP-HP, Le Kremlin-Bicêtre, France
* Tirés à part

Epileptic and psychiatric diseases share overlaps. Indeed, anxiety and depression are common comorbidities in epilepsy, and patients with psychiatric disease are at risk of epilepsy. Some antiepileptic drugs (AED) have psychiatric side effects; conversely, some AED could be used to treat psychiatric pathologies. Based on current literature data, the aim of this study is to determine the psychiatric effects induced by the most frequently prescribed AED in epileptic adults. Some AED will have positive mood or anxiolytic effects like sodium channel blockers, valproate and benzodiazepines; conversely, others might induce negative psychiatric effect, especially depression, anxiety or aggression, like levetiracetam, perampanel, topiramate, zonisamide, and barbiturates. The main risk factor for presenting these side effects is a personal history of psychiatric pathology. We therefore recommend monitoring the occurrence of psychiatric side effects, especially when using the most at risk AED and/or in case of psychiatric history. Moreover, in this latter case, it is preferable to use AED with positive psychiatric effects. The use of anxiety and depression scales could be useful detection tools.