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      Efeitos psiquiátricos e comportamentais das drogas antiepilépticas e sua ação como moduladores de humor Translated title: Psychiatric and behavioral effects of the antiepileptic drugs and their action as mood stabilizers

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          Abstract

          INTRODUÇÃO: Um dos aspectos mais estudados da epileptologia atual é a associação existente entre os transtornos psiquiátricos (TP) e as drogas antiepilépticas (DAE). De acordo com dados recentes na literatura, as DAE podem exercer um papel protetor ou de predisposição ao aparecimento de TP. OBJETIVO: O presente trabalho tem como objetivo fazer uma revisão dos efeitos psiquiátricos e comportamentais das DAE e de sua ação como estabilizadores do humor, bem como de relacionar seu papel protetor ou de predisposição ao aparecimento de TP com seus respectivos mecanismos de ação. CONCLUSÃO: As DAE não apresentam apenas propriedades antiepilépticas, possuindo também efeitos comportamentais positivos ou negativos. O aparecimento de TP, no entanto, está associado tanto ao mecanismo de ação da DAE como à predisposição individual e à condição emocional preexistente do paciente.

          Translated abstract

          INTRODUCTION: The association between epilepsy, psychiatric disorders (PD) and antiepileptic drugs (AED) is among the most frequent and important aspects of epileptology. According to most recent data in literature, AED can act as protecting or predisposing to psychiatric disorders. OBJECTIVE: Data regarding the psychiatric and behavioral effects of AED and its action as mood stabilizers were reviewed. In addition, we discuss the relationship between AED effects in predisposing or protect against PD and its respective mechanism of action. CONCLUSION: AED do not have only antiepileptic properties, but may be associated to positive or negative behaviors. However, the appearance of PD is associated to both AED mechanism of action and the patient's individual predisposing.

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          Most cited references28

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          Major depression is a risk factor for seizures in older adults.

          We tested the hypothesis that major depression meeting DSM-III-R criteria or medical therapies for depression increase the risk for unprovoked seizures. Major depression was associated with a sixfold increased risk for unprovoked seizures (95% CI, 1.56-22). The risk remained increased even when controlling for age, sex, length of medical follow-up, and medical therapies for depression. In the absence of known prior neurological insult, major depression is associated with an increased risk for unprovoked seizures.
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            The psychiatric comorbidity of epilepsy.

            Several studies have assessed the prevalence of psychiatric disorders in epilepsy. They are characterized by considerable heterogeneity, because of differences in the population setting and type of study. A non-systematic review of the literature allows us to draw some useful, although not definite, conclusions. Six per cent of people with epilepsy in the general population appear to suffer from a psychiatric disorder, while this rises to 10-20% in populations with temporal lobe and/or refractory epilepsy. Mood disorders are the most common culprit (24-74%), particularly depression (30%), followed by anxiety disorders (10-25%), psychoses (2-7%) and personality disorders (1-2%). This comorbidity appears to be related to endogenous and exogenous (including iatrogenic) factors and to the severity and chronicity of epilepsy. Conditions such as schizophrenia-like psychosis of epilepsy and interictal dysphoric disorder are represented only in epilepsy. Adequate recognition and treatment of psychiatric conditions in epilepsy is essential for patient management because of their considerable burden in morbidity and quality of life.
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              Psychiatric comorbidity in epilepsy.

              Many studies on psychiatric comorbidity in epilepsy have been performed using many different patient groups and diagnostic instruments. This methodological heterogeneity complicates comparison of the findings. In this article, psychiatric disorders in epilepsy are reviewed from the perspective of the DSM classification system. The empirical findings of axis I clinical disorders and axis II personality disorders are described separately. Furthermore, the existence and specificity of conditions such as interictal dysphoric disorder, interictal behavior syndrome, and psychosis of epilepsy are discussed. From the many studies that have been performed on this topic it can be learned that there is a need for well-controlled studies using representative patient groups and valid and standardized diagnostic instruments. So far, the majority of the studies have concerned axis I disorders; relatively little research has been performed on axis II personality disorders. More research on personality disorders, as well as on the relative contributions of the different (brain- and non-brain-related) factors to the relationship between epilepsy and psychiatric disorders, is recommended.
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                Author and article information

                Journal
                jecn
                Journal of Epilepsy and Clinical Neurophysiology
                J. epilepsy clin. neurophysiol.
                Liga Brasileira de Epilepsia (LBE) (Porto Alegre, RS, Brazil )
                1676-2649
                1980-5365
                2011
                : 17
                : 2
                : 65-69
                Affiliations
                [01] São Paulo orgnameUniversidade Federal de São Paulo orgdiv1Departamento de Neurologia e Neurocirurgia Brasil
                Article
                S1676-26492011000200006 S1676-2649(11)01700206
                10.1590/S1676-26492011000200006
                a91b1c5c-642a-4b5c-92ca-b3b8ea099a4f

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 5
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                SciELO Brazil

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                Artigos de Revisão

                epilepsy,antiepileptic drugs,psychiatric disorders,drogas antiepilépticas,epilepsia,transtornos psiquiátricos

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