Alan Talevi

The association between epilepsies and a wide array of comorbid disorders, including both CNS and non-CNS conditions has long been known. This may be related to neurobiological factors (e.g., common underlying pathophysiology), to the way that the experience of living and dealing with epilepsy affects a person’s view of the world and the person’s locus of control or, most likely, to the interplay between neurobiology and social setting. Several anticonvulsant drugs have proven positive effects on mood disorders, and several drugs used to treat mood disorders have positive effects on seizure control in severe drug resistant epilepsies (e.g., Dravet syndrome). The occurrence of comorbid disorders in patients with epilepsy is associated with a negative prognosis regarding the chances of achieving and sustaining a seizure-free status and, most interesting, some common comorbid disorders such as depression and anxiety are, like epilepsy, associated with abnormal neural networks and poor response to pharmacotherapy. The influence of the psychosocial context on mood disorders has been extensively recognized. Is it possible that its role in epilepsies has been underestimated?