Depressogenic medications and other risk factors for depression among Polish patients with epilepsy

Figures & data

Table 1 Comparison of demographic, clinical, and instrumental findings between depressed and nondepressed patients with epilepsy (univariate analysis)

Variable	Depressed patients (n=84)	Nondepressed patients (n=205)	P-value for the difference
Age	41.3±15.7	33.4±14.0	<0.001
Sex (% of women)	49 (58.3%)	120 (58.5%)	0.97
Marital status (% of living alone)	40 (47.6%)	123 (60.0%)	0.054
Education level
Primary school	6 (7.1%)	23 (11.2%)	0.33
Vocational school	23 (27.4%)	38 (18.5%)
High school	40 (47.6%)	102 (49.8%)
College	15 (17.9%)	42 (20.5%)
Occupational activity (% of active)	29 (34.5%)	82 (40%)	0.38
History of depression	23 (27.4%)	6 (2.9%)	<0.001
Use of antidepressant(s)	20 (23.8%)	6 (2.9%)	<0.001
Comorbidities
Arterial hypertension	14 (16.7%)	25 (12.2%)	0.31
Diabetes	4 (4.8%)	3 (1.5%)	0.11a
Ischemic heart disease	5 (6.0%)	6 (2.9%)	0.19a
Myocardial infarction	2 (2.4%)	2 (1.0%)	0.33a
Hypercholesterolemia	9 (10.7%)	10 (4.9%)	0.07
Asthma	0	6 (2.9%)	–
Hypothyreosis	2 (2.4%)	2 (1.0%)	0.33a
Hyperthyreosis	3 (3.6%)	2 (1.0%)	0.15a
Any comorbidity	20 (23.8%)	35 (17.1%)	0.18
Use of potentially depression-inducing medication(s)	20 (23.8%)	15 (7.3%)	0.0001
Use of other medication(s)a	24 (28.5%)	38 (18.5%)	0.06
Family history of epilepsy	20 (23.8%)	46 (22.4%)	0.80
Family history of depression	16 (19.0%)	26 (12.7%)	0.16
BDI total score	20.5±7.9	7.8±7.7	<0.001
BDI, cognitive-affective subscore	13.3±5.4	4.9±5.1	<0.001
BDI, somatic subscore	7.1±3.7	3.0±1.5	<0.001

Notes:

a Medications other than antiepileptic drugs or depressogenic medications. Data are presented as n (%) or mean ± standard deviation.

Abbreviation: BDI, Beck Depression Inventory.

Table 2 Comparison of epilepsy characteristics between depressed and nondepressed patients with epilepsy (univariate analysis)

Variable	Depressed patients (n=84)	Nondepressed patients (n=205)	P-value for the difference
Age at onset of epilepsy	24.9±17.2	19.4±14.2	0.006
Disease duration	16.4±11.9	14.0±11.1	0.10
Type(s) of seizures
Simple partial	11 (13.3%)	34 (16.6%)	0.46
Complex partial	49 (58.3%)	80 (39.0%)	0.003
Secondary generalized	52 (61.9%)	107 (52.2%)	0.13
Absence	9 (10.7%)	22 (10.7%)	0.99
Myoclonic	5 (6.0%)	22 (10.7%)	0.20
Primary generalized	13 (15.5%)	47 (22.9%)	0.16
Unclassified	9 (10.7%)	24 (11.7%)	0.81
Treatment
Valproate	43 (51.2%)	128 (62.4%)	0.08
Carbamazepine	15 (17.9%)	47 (22.9%)	0.34
Phenobarbital	3 (3.6%)	7 (3.4%)	0.59
Primidone	1 (1.2%)	5 (2.4%)	0.44
Phenytoin	4 (4.8%)	4 (2.0%)	0.17
Clonazepam	5 (6.0%)	4 (2.0%)	0.08
Lamotrigine	13 (15.5%)	26 (12.7%)	0.53
Topiramate	16 (19.0%)	22 (10.7%)	0.057
Vigabatrin	0	2 (1.0%)	–
Levetiracetam	27 (32.1%)	43 (21.0%)	0.044
Tiagabine	0	2 (1.0%)	–
Gabapentin	2 (2.4%)	12 (5.9%)	0.17
Oxcarbazepine	17 (20.2%)	19 (9.3%)	0.01
Ethosuximide	0	2 (1.0%)	–
Clobazam	1 (1.2%)	0	–
Number of AEDs
Monotherapy	37 (44.0%)	124 (60.5%)	0.011
2	33 (39.3%)	49 (23.9%)	0.008
3	13 (15.5%)	29 (14.4%)	0.77
4	1 (1.2%)	2 (1.0%)	0.64
5	0	1 (0.5%)	–
Frequent seizures (>1 per month)	45 (53.6%)	62 (30.2%)	0.0002
No seizures in the previous year	19 (22.6%)	71 (34.6%)	0.045

Note: Data are presented as n (%) or mean ± standard deviation.

Abbreviation: AED, antiepileptic drug.

Table 3 Independent predictors of depression among studied patients with epilepsy (logistic regression model with backwards elimination)a

Variable	Standard error	Wald statistics	P-value	Odds ratio (95% confidence interval)
Frequent seizuresb	0.288	9.55	0.002	2.43 (1.38–4.29)
Use of potentially depression-inducing medication(s)	0.405	8.82	0.003	3.33 (1.50–7.39)
Agec	0.010	7.99	0.005	1.03 (1.01–1.05)
Use of oxcarbazepine	0.394	4.28	0.038	2.26 (1.04–4.90)

Notes:

a The following variables were removed during consecutive steps of backward elimination: monotherapy (P=0.93), age at onset of epilepsy (P=0.99), duration of disease (P=0.83), marital status (P=0.78), hypercholesterolemia (0.62), complex partial seizures (P=0.39), use of medications other than antiepileptic drugs or depressogenic ones (P=0.37), use of levetiracetam (P=0.30), use of valproic acid (P=0.24), any comorbidity (P=0.10), use of clonazepam (P=0.06), and use of topiramate (P=0.06).

b Seizures more frequent than 1 per month.

c Odds ratio for the difference of 1 year.