• Keziya Ann Mammen School of Pharmaceutical Sciences, Vels Institute of Science Technology and Advanced Studies, Vels University, Pallavaram, Chennai, Tamil Nadu, India.
  • Sathesh Kumar S School of Pharmaceutical Sciences, Vels Institute of Science Technology and Advanced Studies, Vels University, Pallavaram, Chennai, Tamil Nadu, India.


Epilepsy is one of the common neurological disorders that are seen worldwide. It can also affect a person’s social, mental, and physiological well-being and thus restricts and disables the common living of man. Depression as such has been well reported in patients with epilepsy, and also depression itself remains a factor that can lead to the development of epilepsy. Increased rates of suicidal tendencies are also associated with depression both in men and women. Depression is further extended in affecting the quality of life in epileptic patients. Depressive rates are found to have a higher value in epileptic patients when compared with the normal population. This article aims to produce a comprehensive review of the epidemiological considerations, clinical findings and management strategies for depression associated with epilepsy.

Keywords: Epilepsy, Comorbidity, Depression, Suicide, Anxiety.

Author Biography

Keziya Ann Mammen, School of Pharmaceutical Sciences, Vels Institute of Science Technology and Advanced Studies, Vels University, Pallavaram, Chennai, Tamil Nadu, India.

Professor and HOD,
Department of Pharmacuetics,
School of Pharmaceutical Sciences,
Vels Institute of Science Technology and Advanced Studies (VISTAS),
Vels University,
Pallavaram, Chennai-600117.


1. Mehta S, Tyagi A, Tripathi R, Kumar M. Study of inter-relationship of depression, seizure frequency and quality of life of people with epilepsy in India. Ment Illn 2014;6(1): 5169.
2. Scévola L, Sarudiansky M, Lanzillotti A, Oddo S, Kochen S, D’Alessio L. To what extent does depression influence quality of life of people with pharmacoresistant epilepsy in Argentina? Epilepsy Behav 2017;69:133-8.
3. Jackson MJ, Turkington D. Depression and anxiety in epilepsy. J Neurol Neurosurg Psychiatry 2005;76 Suppl 1:i45-7.
4. Tegegne MT, Mossie TB, Eshetu DA. Depression and Anxiety disorder among epileptic people at amanuel specialized mental hospital, Addis Ababa, Ethiopia. BMC Psychiatry 2015;15:210.
5. Mendez MF, Cummings JL, Benson DF. Depression in epilepsy. Significance and phenomenology. Arch Neurol 1986;43(8):766-70.
6. Robertson MM, Trimble MR. Depressive illness in patients with epilepsy: A review. Epilepsia 1983;24(2):S109-16.
7. American Association for the Advancement of Science. Epilepsy and Depression-A Two Way Street? Science Daily. Washington, DC: American Association for the Advancement of Science; 2005.
8. Kanner AM. Depression in epilepsy: A complex relation with unexpected consequences. Curr Opin Neurol 2008;21(2):190-4.
9. Harden CL. The co-morbidity of depression and epilepsy: Epidemiology, etiology, and treatment. Neurology 2002;59 6 Suppl 4:S48-55.
10. Colin BJ, Mark L, Isabelle V, Tolulope TS, Scott P, Nathalie J, et al. Association of depression and treated depression with epilepsy and seizure outcomes: A multicohort analysis. JAMA Neurol 2017;74:533-9.
11. Attarian H, Vahle V, Carter J, Hykes E, Gilliam F. Relationship between depression and intractability of seizures. Epilepsy Behav 2003;4(3):298-301.
12. Gilliam F, Kuzniecky R, Meador K, Martin R, Sawrie S, Viikinsalo S, et al. Patientoriented outcome assessment after temporal lobectomy for refractory epilepsy [see comments]. Neurology 1999;53(4):687-94.
13. Cockerell OC, Moriarty J, Trimble M, Sander JW, Shorvon SD. Acute psychological disorders in patients with epilepsy: A nation-wide study. Epilepsy Res 1996;25(2):119-31.
14. Mula M, Schmitz B, Jauch R, Cavanna A, Cantello R, Monaco F, et al. On the prevalence of bi-polar disorder in epilepsy. Epilepsy Behav 2008;13:658-61.
15. Hackett R, Hackett L, Bhakta P. Psyciatric disorder and cognitive function in children with epilepsy in Kerala, South India. Seizure 1998;7:321-4.
16. Rutter M, Tizard J, Whitmore K. In: Boyle MH, editor. Education: Health and Behaviour. Huntington, NY: Robert Krieber Publishing Company; 1981.
17. Kogeorgos J, Fonagy P, Scott DF. Psychiatric symptom patterns of chronic epileptics attending a neurological clinic: A controlled investigation. Br J Psychiatry 1982;140:236-43.
18. Ettinger A, Reed ML, Goldberg JF, Hirschfeld RM. Prevalence of bi-polar symptoms in epilepsy versus other chronic health disorders. Neurology 2005;65(4):535-40.
19. Burton K, Rogathe J, Whttaker RG, Mankad K, Hunter E, Burton MJ, et al. Co-morbidity of epilepsy in Tanzanian children: A community-based case-control-study. Seizure 2012;21(3):169-74.
20. Gaitatzis A, Trimble MR, Sander JW. The psychiatric comorbidity of epilepsy. Acta Neurol Scand 2004;110(4):207-20.
21. Tellez-Zenteno JF, Patten SB, Jette N, Williams J, Wiebe S. Psychiatric co-morbidity in epilepsy: A population-based analysis. Epilepsia 2007;48(12):2336-44.
22. Nidhinandana S, Chinvarun Y, Sithinamsuwan P, Udommongkol C, Suwantamee J, Wongmek W, et al. Prevalence of depression among epileptic patients at Phramongkutklao hospital. J Med Assoc Thai 2007;90(1):32-6.
23. Ting Z, Ming-Yue S, Yu PM, Zhu GX, Xing-Hua T, Yun-Bo S, et al. Evaluation of clinical aspects and quality of life as risk factors for depression in patients with epilepsy. Seizure 2012;21:367-70.
24. Mohammadi MR, Ghanizadeh A, Davidian H, Mohammadi M, Norouzian M. Prevalence of epilepsy and comorbidity of psychiatric disorders in Iran. Seizure 2006;15(7):476-82.
25. Sajjadur R, Kalita KK, Aparajeeta B. A hospital based cross sectional study on comorbid psychiatric problems in persons with epilepsy from north eastern part of India. Int J Epilepsy 2017;4(1):31-5.
26. Asadi-Pooya AA, Sperling MR. Depression and anxiety in patients with epilepsy, with or without other chronic disorders. Iran Red Crescent Med J 2011;13(2):112-6.
27. Kiko N. Prevalence and factors associated with depression among patients with epilepsy in a Kenyan tertiary care hospital. Nairobi, Kenya: Aga Khan University; 2013.
28. Victoroff J. DSM-III-R psychiatric diagnoses in candidates for epilepsy surgery: Lifetime prevalence. Cogn Behav Neurol 1994;7(2)87-97.
29. de Araujo GM, Rosa VP, Caboclo LO, Sakamoto AC, Yacubian EM. Prevalence of psychiatric disorders in patients with mesial temporal sclerosis. J Epilepsy Clin Europhysiol 2007;13(1):13-6.
30. Mensah SA, Beavis JM, Thapar AK, Kerr M. The presence and clinical implications of depression in a community population of adults with epilepsy. Epilepsy Behav 2006;8(1):213-9.
31. Vujisic S, Vodopic S, Radulovic L, Injac-Stevovic L. Psychiatric comorbidities among patients with epilepsy in Montenegro. Acta Clin Croat 2014;53(4):411-6.
32. Bifftu BB, Dachew BA, Tiruneh BT, Birhan Tebeje N. Depression among people with epilepsy in Northwest Ethiopia: A cross-sectional institution based study. BMC Res Notes 2015;8:585.
33. Briellmann RS, Hopwood MJ, Jackson GD. Major depression in temporal lobe epilepsy with hippocampal sclerosis: Clinical and imaging correlates. J Neurol Neurosurg Psychiatry 2007;78(11):1226-30.
34. Yousafzai AU, Yousafzai AW, Taj R. Frequency of depression in epilepsy: A hospital based study. J Ayub Med Coll Abbottabad 2009;21(2):73-5.
35. Barrowclough B. Suicide and epilepsy. In: Reynolds FH, Trimble MR, editors. Epilepsy and Psychiatry. Edinburgh: Churchill-Livingstone; 1981. p. 72-6.
36. Kanner AM, Nieto JC. Depressive disorders in epilepsy. Neurology 1999;53 5 Suppl 2:S26-32.
37. Mbewe EK, Uys LR, Nkwanyana NM, Birbeck GL. A primary healthcare screening tool to identify depression and anxiety disorders among people with epilepsy in Zambia. Epilepsy Behav 2013;27(2):296-300.
38. Kanner AM, Schachter SC, Barry JJ, Hesdorffer DC, Mula M, Trimble M, et al. Depression and epilepsy: Epidemiologic and neurobiologic perspectives that may explain their high comorbid occurrence. Epilepsy Behav 2012;24(2):156-68.
39. Ettinger A, Reed M, Cramer J. Depression and comorbidity in community-based patients with epilepsy or asthma. Neurology 2004;63(6):1008-14.
40. Stefanello S, Marín-Léon L, Fernandes PT, Li LM, Botega NJ. Depression and anxiety in a community sample with epilepsy in Brazil. Arq Neuropsiquiatr 2011;69(2B):342-8.
41. Wazir A, Khosa NA, Amaullah S. To determine the frequency of depression in patients with primary epilepsy. Pak J Neurol Sci 2014;9(3):8-11.
42. Onwuekwe I, Ekenze O, Bzeala-Adikaibe, Ejekwu J. Depression in patients with epilepsy: A study from Enugu, South East Nigeria. Ann Med Health Sci Res 2012;2(1):10-3.
43. de Leo D, Bertolote J, Lester D. Self-directed violence. In: Krug EG, Dahlberg LL, Mercy JA, Lozano R, editors. World Report on Violence and Health. Geneva: World Health Organization; 2002. p. 183-212.
44. Moscicki EK. Epidemiology of suicidal behaviour. In: Silverman MM, Maris RW, editors. Suicide Prevention: Toward the Year 2000. New York: Guilford; 1985. p. 22-35.
45. Moscicki EK. Epidemiology of completed and attempted suicide: Toward a framework for prevention. Clin Neurosci Res 2001;1:310-23.
46. Nilsson L, Ahlbom A, Farahmand BY, Asberg M, Tomson T. Risk factors for suicide in epilepsy: A case control study. Epilepsia 2002;43(6):644-51.
47. Christensen J, Vestergaard M, Mortensen PB, Sidenius P, Agerbo E. Epilepsy and risk of suicide: A population-based case-control study. Lancet Neurol 2007;6(8):693-8.
48. Qin P, Xu H, Laursen TM, Vestergaard M, Mortensen PB. Risk for schizophrenia and schizophrenia-like psychosis among patients with epilepsy: Population based cohort study. BMJ 2005;331(7507):23.
49. Jones JE, Hermann BP, Barry JJ, Gilliam FG, Kanner AM, Meador KJ. Rates and risk factors for suicide, suicidal ideation, and suicide attempts in chronic epilepsy. Epilepsy Behav 2003;4 Suppl 3:S31-8.
50. Andrijic NL, Alajbegovic A, Zec SL, Loga S. Suicidal ideation and thoughts of death in epilepsy patients. Psychiatr Danub 2014;26(1):52-5.
51. Andersohn F, Schade R, Willich SN, Garbe E. Use of antiepileptic drugs in epilepsy and the risk of self-harm or suicidal behavior. Neurology 2010;75(4):335-40.
52. Pompili M, Girardi P, Ruberto A, Tatarelli R. Suicide in the epilepsies: A meta-analytic investigation of 29 cohorts. Epilepsy Behav 2005;7(2):305-10.
53. Hesdorffer DC, Hauser WA, Olafsson E, Ludvigsson P, Kjartansson O. Depression and suicide attempt as risk factors for incident unprovoked seizures. Ann Neurol 2006;59(1):35-41.
54. Ahmad N, Othaman NI, Islahudin F. Medication adherence and quality of life in epilepsy patients. Int J Pharm Sci Res 2013;5(2):401-4.
55. Mebanga O, Allen SN. Treatment of depression in patients with epilepsy. US Pharm 2012;37(11):29-32.
56. Lahat E, Goldman M, Barr J, Bistritzer T, Berkovitch M. Comparison of intranasal midazolam with intravenous diazepam for treating febrile seizures in children: Prospective randomised study. BMJ 2000;321(7253):83-6.
57. Robertson MM, Trimble MR. The treatment of depression in patients with epilepsy: A double-blinded trial. J Affect Disord 1985;9(2):127-36.
58. Devinsky O, Barr WB, Vickrey BG, Berg AT, Bazil CW, Pacia SV, et al. Changes in depression and anxiety after resective surgery for epilepsy. Neurology 2005;65(11):1744-9.
59. Brent DA, Crumrine PK, Varma RR, Allan M, Allman C. Phenobarbital treatment and major depressive disorder in children with epilepsy. Pediatrics 1987;85(6):1086-91.
60. Santosh P, Venugopl R, Nilakash AS, Kunjbihari S, Mangala LD. Anti depressant activity of methanolic extract of Passiflora foetida leaves in mice. Int J Pharm Pharm Sci 2011;3(1):112-5.
61. Singh P, Singh D, Goel RK. Phytoflavonoids: Anti-epileptics for the future. Int J Pharm Pharm Sci 2017;6(8):51-66.
62. Deka D, Chakravarthy P, Purkayastha A. Evaluation of the anticonvulsant effect of aqueous extract of Centella asiatica in Albino mice. Int J Pharm Pharm Sci 2017;9(2):312-4.
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How to Cite
Mammen, K. A., and S. K. S. “A COMPREHENSIVE REVIEW ON COMORBID DEPRESSION IN PATIENTS WITH EPILEPSY”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 10, no. 12, Dec. 2017, pp. 30-35, doi:10.22159/ajpcr.2017.v10i12.18938.
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