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 Possible links between depression and epilepsy have been noted since around 400 B.C., when Hippocrates, reportedly observed, "Melancholics ordinarily become epileptics and epileptics melancholics." Galen, another Greek physician, later wrote a treatise titled "Epilepsy and Melancholy."
Researchers from Rush University Medical Center reported this weekend at the The American Association for the Advancement of Science (AAAS) annual meeting that there is a higher incidence of depression among patients with epilepsy than the general population or in others with chronic medical conditions.
Interestingly enough, these scientists view this as a "two-way street" and suggest that individuals with a history of depression have a 3 to 7 times higher risk of developing epilepsy. It was generally believed that depression was a complication of epilepsy but this new research points to a common pathogenic mechanism.
Common pathways between depression and epilepsy might account for recent data suggesting that patients with a psychiatric history may not respond as well to medication or surgery for treatment of their seizures. Andres Kanner and colleagues recently studied 90 patients whose seizures failed to respond to antiepileptic medication and underwent brain surgery to remove tissue that was the focus of the seizures. Patients with a lifetime history of depression were less likely to become seizure-free, the researchers found. This suggests depression could be a biological marker for a more severe form of epilepsy.
Whatever biological links the two disorders may share, clinicians and patients alike need to be more aware of the significant incidence of depression among those with epilepsy. Ettinger and colleagues surveyed 775 epilepsy patients in community settings, 395 asthma patients and 362 healthy control subjects. Among those with epilepsy, 36.5 percent reported symptoms of depression, compared to 27.8 percent of asthmatics and 11.8 percent of controls. The study, published in the journal Neurology also found that nearly 39 percent of the patients with epilepsy had never been evaluated for depression.
It is important for doctors and patients to understand that those with epilepsy, even mild forms of the condition, face an elevated risk of depression. In addition, clinicians should routinely assess for seizure disorders in patients presenting with depression.
11:57:46 PM 
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