Depression Increases Epilepsy Risk, Makes it Harder to Treat

People with depression have more than double the risk of developing epilepsy, a new study says. In a separate study, researchers found that depression makes epilepsy more difficult to treat.

For the first study, researchers found that depression led to a 2.4-times increased risk of developing epilepsy, based on data pooled from eight prior studies.

“Our findings show a consistent association that suggests an increased risk of developing epilepsy after depression, but they do not show that depression causes epilepsy,” lead researcher Dr. Ali Rafati, a postdoctoral research fellow at Johns Hopkins University School of Medicine in Baltimore, said. “We need to learn more about the biological connection, but the link between depression and epilepsy could be related to shared brain networks, stress and inflammation pathways, and sleep issues,” Rafati added.

For the second study, researchers analyzed data on more than 90,000 people recently diagnosed with epilepsy. Results showed that those with depression were 40% more likely to not be adequately helped by their first antiseizure medication.

“People with epilepsy are known to be at higher risk for mood disorders, but our study uncovers new information that those with depression are more likely to fail their first treatment,” lead researcher Dr. Samuel Terman, an assistant professor of neurology at the University of Michigan in Ann Arbor, said.

Patients who “failed” their first antiseizure drug—meaning that they stopped taking it, had to switch to a different drug, or add another antiseizure med to their regimen. People with epilepsy and depression were also more likely to have other mental health problems, including anxiety, sleep disorders, psychosis, and bipolar disorder. People with both conditions also had higher rates of heart problems, lung diseases, diabetes, and kidney disease.

“Depression could affect epilepsy treatment in various ways, such as influencing a person’s motivation to continue medication, making their complex drug regimen too challenging, or magnifying side effects,” Terman said. “Or they may have other neurological conditions that may worsen seizures or medication tolerance. This underscores the importance of integrating mental health care into epilepsy treatment to keep patients on effective therapies longer and improve outcomes.”

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