News - Depression
and anxiety improve after epilepsy surgery
17 January 2006
A new study has found that successful surgery
for intractable epilepsy can dramatically
improve symptoms of depression and anxiety.
Dr Orrin Devinsky and colleagues of the
New York University School of Medicine studied
358 patients with depression or anxiety
who underwent surgery for their epilepsy,
to find out how the operation affected their
mental health. They found that in a significant
number of patients, depression and anxiety
symptoms were reduced.
Depression and anxiety are more common
in patients with epilepsy than in the general
population. These conditions can be caused
by psychological factors (e.g. fear of seizures,
reduced quality of life due to lifestyle
restrictions), the direct effects of the
seizures themselves on the brain, or the
effects of anti-epileptic drugs. Depression
can also occur as an aura before a seizure,
and it is also common immediately after
a seizure.
This
study, published in December in the
journal Neurology, followed patients
who had epilepsy that was unresponsive to
treatment with anti-epileptic medication,
who were put forward for surgery. They were
assessed for symptoms of anxiety or depression
before their operation, and again three
months, twelve months and two years after
surgery.
A total of 22.1% of patients reported symptoms
of depression before surgery, but only 11.7%
reported depressive symptoms after surgery.
Nearly 25% showed symptoms of anxiety before
surgery; this rate declined to 13.0% two
years later. These are decreases of more
than 50%. Lower rates of depression and
anxiety were recorded from three months
after surgery. Patients who became seizure
free after surgery reported a greater reduction
of depression and anxiety symptoms than
those who continued to experience seizures.
The area of the brain where seizures occurred
on did not appear to affect the outcome
at all.
Researchers are not sure why this effect
occurs. The increased quality of life that
comes with seizure freedom may be part of
it, but the stopping of the direct effects
of seizures and anti-epileptic drugs on
the mood mechanisms in the brain may also
be important.
