Эпилепсия и пароксизмальные состояния (Dec 2016)

THE SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRI) AS TREATMENT OF DEPRESSION IN PATIENTS WITH EPILEPSY

  • Yu. V. Solomatin,
  • Yu. V. Rubleva

DOI
https://doi.org/10.17749/2077-8333.2016.8.3.011-018
Journal volume & issue
Vol. 8, no. 3
pp. 11 – 18

Abstract

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The current possibilities of treatment of depression in epilepsy were represented. Depression is one of the most frequent psychiatric comorbidities in epilepsy. The prevalence of depression ranges from 10 to 80%, and most often found in patients with focal epilepsy resistant to antiepileptic therapy. Depression in patients with epilepsy are not often diagnosed and therefore not treated. A number of common epilepsy and depression pathogenetic mechanisms, such as impaired metabolism of certain neurotransmitters in the central nervous system, especially serotonin was descripted. Based on this, the most promising drugs in the treatment of depression in epilepsy are now the selective serotonin reuptake inhibitor (SSRI), such as escitalopram. Objective. The primary objectives were to evaluate the efficacy and safety of escitalopram in treating depressive symptoms. Materials and methods. The study involved 68 patients aged 19-69 years with cryptogenic and focal epilepsy and different disease duration (from 5 to 21 years), different types of seizures and suffering depression interictal (between 2 and 5.5 years). Depression Rating Scale of Montgomery-Asberg (MADRS) was used. To assess the severity of the patient ’s condition at the time of the survey, a global assessment of disease severity (CGI-S) and the global assessment of the mental state (CGI-I) were used. While taking escitalopram (10-20 mg per day.), all patients received basic anticonvulsant therapy. Results. During follow-up the patients with epilepsy who took escitalopram, proconvulsant effect were not denoted. In assessing depressive symptoms improved markedly. Against the background of escitalopram no deterioration was marked, no sedation, addiction to the drug was observed, minimum drug interactions with anticonvulsants was registered. Conclusion. The results described observation program suggests a safe and effective treatment of escitalopram epilepsy patients with depression, it is well tolerated, low drugdrug interactions, as well as improve the quality of life of patients.

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