Depression, Epilepsy, and Suicide May Be Linked
Depression Could Be Early Sign of Brain Dysfunction Leading to Seizures
Seizures Don't Explain Depression continued...
In an effort to clarify the relationship between depression, suicide, and epilepsy, Columbia University researchers compared people with unprovoked seizures with those without the condition who were enrolled in a health registry in Iceland.
An unprovoked seizure was defined as a seizure without an identified precipitant such as fever, head trauma, or brain infections.
Among the symptoms associated with depression, only suicidal attempts were shown to be a risk factor for developing unprovoked seizures. The association remained strong after other suicide risk factors were considered.
The study is published in the November issue of the journal Annals of Neurology.
Hesdorffer says the findings have implication for the management of patients who have recently been diagnosed with epilepsy.
"Increasingly, clinicians treating people with epilepsy ask about current depression, but they may not ask about past suicide attempts or suicidal thoughts," Hesdorffer says. "Our results may alert clinicians to the need to ask this question and offer any needed counseling to prevent [later] suicide."
The findings may also help explain why the suicide rate among epileptics is so high.
In April, the FDA asked more than a dozen pharmaceutical companies to reexamine their study data involving seizure medications to determine if these drugs could be linked to suicidal thoughts or behaviors.
Psychologist Bruce Hermann, PhD, tells WebMD that there is evidence that depression and depression-related symptoms precede other neurological diseases like Alzheimer's and Parkinson's disease.
Hermann is chair elect of the Epilepsy Foundation's professional advisory board, and he is also a neurology professor at the University of Wisconsin.
"Clearly some people get depressed because they are living with a chronic disease, but depression could also be an early sign that something is not right within the brain," he says.
He agrees that physicians need to evaluate their epileptic patients for depression. According to one study, more than half of patients with both disorders never get treated for depression.
"If it is true that mood disorders and these other problems occur before or close in time to when the epilepsy starts, it is important to look for these symptoms and treat them," he says.