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.