Depression in patients receiving pharmacotherapy for epilepsy: An audit in a tertiary care centre.
Adolescent
Adult
Aged
Anticonvulsants
/ administration & dosage
Child
Cross-Sectional Studies
Depression
/ chemically induced
Epilepsy
/ drug therapy
Female
Humans
Levetiracetam
/ administration & dosage
Male
Middle Aged
Patient Health Questionnaire
Prevalence
Risk Factors
Tertiary Care Centers
Young Adult
AED load
Adverse effects
Depression
HADS-D
Newer antiepileptic drugs
PHQ-2
Polytherapy
Journal
Pharmacological reports : PR
ISSN: 2299-5684
Titre abrégé: Pharmacol Rep
Pays: Switzerland
ID NLM: 101234999
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
06
02
2019
revised:
24
04
2019
accepted:
29
04
2019
pubmed:
10
8
2019
medline:
1
5
2020
entrez:
10
8
2019
Statut:
ppublish
Résumé
The association of depression and epilepsy is thought to be bidirectional. The present study aimed to evaluate the prevalence of depression in patients on antiepileptic drugs (AEDs) and factors affecting it. In this preliminary cross sectional study, patients at epilepsy clinic of a tertiary care centre were studied for occurrence of depression, using Hospital Anxiety and Depression Scale (HADS-D) and Patient Health Questionnaire (PHQ-2) scales. Correlation analysis was carried out to determine the factors associated with presence of depression in these patients. A total of 12 AEDs (maximum 5 per patient including older and newer) were prescribed to 933 patients in different treatment regimens over a period of 3 years. The median age of the patients was 22 years (10-77) and among them 63.5% were men. Mild and clinically relevant depression occurred in 279 (29.9%) and 223 (23.9%) patients, respectively. Mean HADS-D and PHQ-2 score was significantly higher with polytherapy as compared to monotherapy (p < 0.001). Patients on levetiracetam exhibited significantly higher HADS-D score in comparison to phenytoin (p < 0.001), carbamazepine (p < 0.001) and sodium valproate (p < 0.05). However, there was no significant difference in PHQ score among patients on monotherapy of different AEDs. Multivariate regression analysis suggested correlation between depression and seizure frequency, total number of AEDs and their load (p < 0.001). Depressive symptoms were found to be present in more than half of the patients with epilepsy which require detailed work up for depression. Levetiracetam was found to be associated with a higher incidence of subclinical depression which needs further investigation.
Sections du résumé
BACKGROUND
BACKGROUND
The association of depression and epilepsy is thought to be bidirectional. The present study aimed to evaluate the prevalence of depression in patients on antiepileptic drugs (AEDs) and factors affecting it.
METHODS
METHODS
In this preliminary cross sectional study, patients at epilepsy clinic of a tertiary care centre were studied for occurrence of depression, using Hospital Anxiety and Depression Scale (HADS-D) and Patient Health Questionnaire (PHQ-2) scales. Correlation analysis was carried out to determine the factors associated with presence of depression in these patients.
RESULTS
RESULTS
A total of 12 AEDs (maximum 5 per patient including older and newer) were prescribed to 933 patients in different treatment regimens over a period of 3 years. The median age of the patients was 22 years (10-77) and among them 63.5% were men. Mild and clinically relevant depression occurred in 279 (29.9%) and 223 (23.9%) patients, respectively. Mean HADS-D and PHQ-2 score was significantly higher with polytherapy as compared to monotherapy (p < 0.001). Patients on levetiracetam exhibited significantly higher HADS-D score in comparison to phenytoin (p < 0.001), carbamazepine (p < 0.001) and sodium valproate (p < 0.05). However, there was no significant difference in PHQ score among patients on monotherapy of different AEDs. Multivariate regression analysis suggested correlation between depression and seizure frequency, total number of AEDs and their load (p < 0.001).
CONCLUSION
CONCLUSIONS
Depressive symptoms were found to be present in more than half of the patients with epilepsy which require detailed work up for depression. Levetiracetam was found to be associated with a higher incidence of subclinical depression which needs further investigation.
Identifiants
pubmed: 31398575
pii: S1734-1140(19)30086-6
doi: 10.1016/j.pharep.2019.04.021
pii:
doi:
Substances chimiques
Anticonvulsants
0
Levetiracetam
44YRR34555
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
848-854Informations de copyright
Copyright © 2019. Published by Elsevier B.V.