Depression ‘makes it more likely for patients to miss epilepsy drug doses’

Posted Jun 13 2014 in Conditions related to epilepsy

Epilepsy patients who are also affected by depression may find it harder to stick to their prescribed antiepileptic drug regimens, according to new US research.

To be published in the Epilepsy & Behavior journal, this is the first study to show a direct link between depression and medication nonadherence among epilepsy patients. The condition has previously been linked to missed doses among people with hypertension and HIV.

The new research assessed data from a US health plan/pharmacy database, selecting a sample of 10,000 epilepsy patients. Of these, 2,750 were randomly selected and mailed an in-depth survey that included questions about medication adherence, depression status, seizure severity and frequency, and general quality of life.

A total of 465 patients completed and returned the survey. It was found that depression was significantly correlated with an elevated risk of antiepileptic drug nonadherence, as well as a poorer quality of life. People with depression were also shown to be more likely to report having more severe seizures.

Factors thought to play a role in missed dosages are memory difficulties and medication side effects. However, patients should be warned that failing to take medication as directed can cause breakthrough seizures with potentially serious consequences.

As such, doctors may need to do more to screen epilepsy patients for mental health issues, as well as making use of treatment options that make adherence easier, such as once-daily formulations and reminder systems.

Lead author Dr Alan Ettinger said: “There are substantial consequences to missing doses of antiepileptic medications, even occasionally. We have also seen that depression impacts quality of life.

“Now we see that depression is a significant factor in drug nonadherence. This demonstrates that it is critical for physicians to screen their patients for depression and to talk with them about the importance of taking all of their medications when scheduled.”

In around 70 per cent of cases, seizures can be successfully controlled by antiepileptic drugs, making it important that patients do everything they can to stick to their prescribed regimens.

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