Epilepsy surgery improves depression

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According to a new multicenter study patients with epilepsy which does not respond to drug therapy, and who also have depression or anxiety, surgery used to treat the epilepsy often results in improvements in the psychiatric symptoms.

Depression and anxiety are common among patients with epilepsy.

Dr. Orrin Devinsky, from the New York University School of Medicine, and his team followed 360 patients after they had undergone epilepsy surgery to see if these conditions were resolved.

It seems that before surgery, 22.1 percent of the patients had depressive symptoms and 24.7 percent had anxiety symptoms; 24 months after surgery the researchers found that these rates dropped to 11.7 percent and 13.0 percent, respectively.

The results were to some extent 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 apparently no relationship between psychiatric symptoms and the location of the surgery.

Although the reasons why ongoing seizures increase the risk of continued depression after surgery remain unclear, says Devinsky's team, but 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 anti-epileptic medication.

The researchers advise that before epilepsy surgery patients should be informed that symptoms of depression and anxiety improve for most patients.

The research is published in the journal Neurology, December 2005.


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