Current and emerging drug therapies for the treatment of depression in adults with epilepsy

ABSTRACT

Introduction: Depression is the most frequent psychiatric comorbidity among people with epilepsy. It can impact on quality of life and increases the risk of morbidity and premature mortality.

Areas covered: The authors review the available data on current and emerging drug treatments for depression in epilepsy. Sources have been identified through Medline/PubMed searches while ongoing clinical trials have been identified through a ClinicalTrials.gov search.

Expert opinion: SSRIs are the drug class with the largest amount of data. Though promising, the level of evidence provided by these studies is still low as the majority have relevant methodological limitations. Antiepileptic drugs under development have the unique opportunity to be of multi-use in the treatment of epilepsy and depression. The serotoninergic system has already been identified as a potential area of interest, but new targets are still needed in epilepsy and depression. For this reason, it is important that basic scientists working on these two conditions develop collaborative projects and integrate findings.

KEYWORDS:

• Epilepsy
• depression
• SSRIs
• antiepileptic drugs
• antidepressant drugs

Declaration of interest

M Mula has received consultancy fees from UCB Pharma, Eisai, Bial and Elsevier. He also has intellectual property with Springer. JW Sander has received departmental research support from Eisai and UCB Pharma and has been consulted by and has received fees for lecturing from Bial, Eisai, and UCB Pharma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Article highlights

• High evidence outcome data about efficacy and safety of antidepressant drugs in epilepsy are still limited

• It is still unknown whether people with depression and epilepsy have similar remission and recovery rates than those with depression but without epilepsy

• Given the lack of any strong evidence in epilepsy, it seems reasonable to follow internationally accepted guidelines for the treatment of depression outside epilepsy

• It is still unknown whether different epilepsy syndromes are associated with different seizure relapse during treatment with antidepressants

• New potential targets for drug development in both epilepsy and depression are needed

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Additional information

Funding

This manuscript has not been funded.