Abstract: Antidepressiva voor mensen met epilepsie en depressie
Depressive disorders occur in approximately one-third of people with epilepsy, often requiring antidepressant treatment. However, depression often goes untreated in people with epilepsy, partly due to fear that antidepressants might cause seizures. There are different classes of antidepressants, however they all aim to increase key neurotransmitters in the brain, thereby alleviating depressive symptoms.
Characteristics of studies
We carried out a search of databases on 31 May 2014. We found eight studies that included 471 patients with epilepsy treated with an antidepressant. Three were randomised controlled trials and five were non-randomised prospective cohort studies. The studies observed the effect of different antidepressants, mainly a class of antidepressant called a selective serotonin reuptake inhibitor (SSRI).
Taking all the evidence into account, the review found that there is very limited evidence demonstrating a significant effect of antidepressants on depressive symptoms in epilepsy. There was limited information on the effect of antidepressants on seizure control, however in the studies reporting this outcome there did not appear to be any significant worsening of seizures.
Quality of the studies
We assessed the studies with regard to bias and quality. Overall the quality of the evidence was rated as moderate for the clinical trials and low for the non-randomised prospective cohort studies. More high quality, larger trials of antidepressants are needed to examine how different classes of antidepressant compare and what impact they are likely to have on seizure control.
Maguire MJ, Weston J, Singh J, Marson AG. Antidepressants for people with epilepsy and depression. Cochrane Database of Systematic Reviews 2014, Issue 12. Art. No.: CD010682. DOI: 10.1002/14651858.CD010682.pub2