Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Epilepsy: HELP
Articles by Dr. Andrés Kanner
Based on 87 articles published since 2009
(Why 87 articles?)
||||

Between 2009 and 2019, A. Kanner wrote the following 87 articles about Epilepsy.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs II: Treatment-resistant epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society. 2018

Kanner, Andres M / Ashman, Eric / Gloss, David / Harden, Cynthia / Bourgeois, Blaise / Bautista, Jocelyn F / Abou-Khalil, Bassel / Burakgazi-Dalkilic, Evren / Llanas Park, Esmeralda / Stern, John / Hirtz, Deborah / Nespeca, Mark / Gidal, Barry / Faught, Edward / French, Jacqueline. ·From Miller School of Medicine (A.M.K.), University of Miami, FL · Bronson Methodist Hospital (E.A.), Kalamazoo, MI · Charleston Area Medical Center (D.G.), Charleston, WV · Mount Sinai Beth Israel (C.H.), New York, NY · Children's Hospital, Harvard Medical School (B.B.), Boston, MA · Cleveland Clinic Foundation (J.F.B.), OH · Department of Neurology (B.-A.K.), School of Medicine, Nashville, TN · Cooper Medical School (E.B.-D.), Rowan University, Cherry Hill, NJ · Alexian Brothers Medical Group (E.L.P.), Hoffman Estates, IL · School of Medicine (J.S.), University of California in Los Angeles · University of Vermont Medical Center (D.H.), Burlington · Children's Hospital (M.N.), University of California San Diego School of Medicine · School of Pharmacy (B.G.), University of Wisconsin, Madison · Emory University School of Medicine (E.F.), Atlanta, GA · and New York University (J.F.), New York. ·Neurology · Pubmed #29898974.

ABSTRACT: OBJECTIVE: To update the 2004 American Academy of Neurology guideline for managing treatment-resistant (TR) epilepsy with second- and third-generation antiepileptic drugs (AEDs). METHODS: 2004 criteria were used to systemically review literature (January 2003 to November 2015), classify pertinent studies according to the therapeutic rating scheme, and link recommendations to evidence strength. RESULTS: Forty-two articles were included. RECOMMENDATIONS: The following are established as effective to reduce seizure frequency (Level A): immediate-release pregabalin and perampanel for TR adult focal epilepsy (TRAFE); vigabatrin for TRAFE (not first-line treatment); rufinamide for Lennox-Gastaut syndrome (LGS) (add-on therapy). The following should be considered to decrease seizure frequency (Level B): lacosamide, eslicarbazepine, and extended-release topiramate for TRAFE (ezogabine production discontinued); immediate- and extended-release lamotrigine for generalized epilepsy with TR generalized tonic-clonic (GTC) seizures in adults; levetiracetam (add-on therapy) for TR childhood focal epilepsy (TRCFE) (1 month-16 years), TR GTC seizures, and TR juvenile myoclonic epilepsy; clobazam for LGS (add-on therapy); zonisamide for TRCFE (6-17 years); oxcarbazepine for TRCFE (1 month-4 years). The text presents Level C recommendations. AED selection depends on seizure/syndrome type, patient age, concomitant medications, and AED tolerability, safety, and efficacy. This evidence-based assessment informs AED prescription guidelines for TR epilepsy and indicates seizure types and syndromes needing more evidence. A recent Food and Drug Administration (FDA) strategy allows extrapolation of efficacy across populations; therefore, for focal epilepsy, eslicarbazepine and lacosamide (oral only for pediatric use) as add-on or monotherapy in persons ≥4 years of age and perampanel as monotherapy received FDA approval.

2 Guideline Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Epilepsy Society. 2018

Kanner, Andres M / Ashman, Eric / Gloss, David / Harden, Cynthia / Bourgeois, Blaise / Bautista, Jocelyn F / Abou-Khalil, Bassel / Burakgazi-Dalkilic, Evren / Llanas Park, Esmeralda / Stern, John / Hirtz, Deborah / Nespeca, Mark / Gidal, Barry / Faught, Edward / French, Jacqueline. ·From the Miller School of Medicine (A.M.K.), University of Miami, FL · Bronson Neuroscience Center (E.A.), Bronson Methodist Hospital, Kalamazoo, MI · Department of Neurology (D.G.), Charleston Area Medical Center, Charleston, WV · Department of Neurology (C.H.), Mount Sinai Beth Israel, New York, NY · Children's Hospital (B.B.), Harvard Medical School, Boston, MA · Epilepsy Center (J.F.B.), Cleveland Clinic Foundation, OH · Department of Neurology (B.A.-K.), Vanderbilt University, Nashville, TN · Department of Neurology (E.B.-D.), Cooper Medical School, Rowan University, Cherry Hill, NJ · AMITA Health Medical Group (E.L.P.), Hoffman Estates, IL · School of Medicine (J.S.), University of California, Los Angeles · School of Medicine (D.H.), University of Vermont, Burlington · Children's Hospital (M.N.), University of California San Diego School of Medicine · School of Pharmacy (B.G.), University of Wisconsin, Madison · School of Medicine (E.F.), Emory University, Atlanta, GA · and Department of Neurology (J.F.), New York University Langone Comprehensive Epilepsy Center, New York. ·Neurology · Pubmed #29898971.

ABSTRACT: OBJECTIVE: To update the 2004 American Academy of Neurology (AAN) guideline for treating new-onset focal or generalized epilepsy with second- and third-generation antiepileptic drugs (AEDs). METHODS: The 2004 AAN criteria were used to systematically review literature (January 2003-November 2015), classify pertinent studies according to the therapeutic rating scheme, and link recommendations to evidence strength. RESULTS: Several second-generation AEDs are effective for new-onset focal epilepsy. Data are lacking on efficacy in new-onset generalized tonic-clonic seizures, juvenile myoclonic epilepsy, or juvenile absence epilepsy, and on efficacy of third-generation AEDs in new-onset epilepsy. RECOMMENDATIONS: Lamotrigine (LTG) should (Level B) and levetiracetam (LEV) and zonisamide (ZNS) may (Level C) be considered in decreasing seizure frequency in adults with new-onset focal epilepsy. LTG should (Level B) and gabapentin (GBP) may (Level C) be considered in decreasing seizure frequency in patients ≥60 years of age with new-onset focal epilepsy. Unless there are compelling adverse effect-related concerns, ethosuximide or valproic acid should be considered before LTG to decrease seizure frequency in treating absence seizures in childhood absence epilepsy (level B). No high-quality studies suggest clobazam, eslicarbazepine, ezogabine, felbamate, GBP, lacosamide, LEV, LTG, oxcarbazepine, perampanel, pregabalin, rufinamide, tiagabine, topiramate, vigabatrin, or ZNS is effective in treating new-onset epilepsy because no high-quality studies exist in adults of various ages. A recent Food and Drug Administration (FDA) strategy allows extrapolation of efficacy across populations; therefore, for focal epilepsy, eslicarbazepine and lacosamide (oral only for pediatric use) as add-on or monotherapy in persons ≥4 years old and perampanel as monotherapy received FDA approval.

3 Guideline International consensus clinical practice statements for the treatment of neuropsychiatric conditions associated with epilepsy. 2011

Kerr, Mike P / Mensah, Seth / Besag, Frank / de Toffol, Bertrand / Ettinger, Alan / Kanemoto, Kousuke / Kanner, Andres / Kemp, Steven / Krishnamoorthy, Ennapadum / LaFrance, W Curt / Mula, Marco / Schmitz, Bettina / van Elst, Ludgers Tebartz / Trollor, Julian / Wilson, Sarah J / Anonymous2800706. ·Psychological Medicine, University of Wales College of Medicine, Cardiff, United Kingdom. kerrmp@cf.ac.uk ·Epilepsia · Pubmed #21955156.

ABSTRACT: In order to address the major impact on quality of life and epilepsy management caused by associated neuropsychiatric conditions, an international consensus group of epileptologists met with the aim of developing clear evidence-based and practice-based statements to provide guidance on the management of these conditions. Using a Delphi process, this group prioritized a list of key management areas. These included: depression, anxiety, psychotic disorders, nonepileptic seizures, cognitive dysfunction, antiepileptic drug (AED)-related neurobehavioral disorders, suicidality, disorders in children and adolescents, disorders in children with intellectual disability, and epilepsy surgery. Clinical practice statements were developed for each area and consensus reached among members of the group. The assessment and management of these conditions needs to combine knowledge of psychiatric disorders, knowledge of the impact of epilepsy and its treatment on psychopathology, and an ability to deliver care within epilepsy services. The aim of these statements is to provide guidance on quality care for people with epilepsy that have a range of neuropsychiatric disorders.

4 Editorial Association Between Selective Serotonin-Reuptake Inhibitor Antidepressants and Increased Risk of Poststroke Epilepsy. 2017

Kanner, Andres M. ·Miller School of Medicine, University of Miami, Miami, FL. Electronic address: a.kanner@med.miami.edu. ·Mayo Clin Proc · Pubmed #28160869.

ABSTRACT: -- No abstract --

5 Editorial Remember…there is more to epilepsy than seizures! 2015

Kanner, Andres M / Meador, Kimford J. ·From the Miller School of Medicine (A.M.K.), University of Miami, FL · and the Stanford University School of Medicine (K.J.M.), Palo Alto, CA. ·Neurology · Pubmed #26333797.

ABSTRACT: -- No abstract --

6 Editorial Introduction to epilepsies: complexity and comorbidities. 2014

Schachter, Steven C / Garcia-Cairasco, Norberto / Kanner, Andres M. ·Departments of Neurology, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: sschacht@bidmc.harvard.edu. · Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil. · Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA. ·Epilepsy Behav · Pubmed #25260239.

ABSTRACT: -- No abstract --

7 Editorial Psychiatric comorbidities and epilepsy: is it the old story of the chicken and the egg? 2012

Kanner, Andres M. · ·Ann Neurol · Pubmed #22926848.

ABSTRACT: -- No abstract --

8 Review Classification of paroxysmal events and the four-dimensional epilepsy classification system. 2019

Lüders, Hans / Vaca, Guadalupe Fernandez-Baca / Akamatsu, Naoki / Amina, Shahram / Arzimanoglou, Alexis / Baumgartner, Christoph / Benbadis, Selim R / Bleasel, Andrew / Bermeo-Ovalle, Adriana / Bozorgi, Alireza / Carreño, Mar / Devereaux, Michael / Francione, Stefano / Losarcos, Naiara García / Hamer, Hajo / Holthausen, Hans / Jamal-Omidi, Shirin / Kalamangalam, Giri / Kanner, Andrés M / Knake, Susanne / Lacuey, Nuria / Lhatoo, Samden / Lim, Shih Hui / Londoño, Luisa V / Mani, Jayanti / Matsumoto, Riki / Miller, Jonathan P / Noachtar, Soheyl / Palmini, André / Park, Jun / Rosenow, Felix / Shahid, Asim / Schuele, Stephan / Steinhoff, Bernhard J / Ákos Szabó, Charles / Tandon, Nitin / Terada, Kiyohito / Boas, Walter van Emde / Widdess-Walsh, Peter / Kahane, Philippe. ·Case medical Center - Neurology, Cleveland, Ohio, USA. · University Hospitals Ringgold standard institution - Neurology, Cleveland, Ohio, USA. · International University of Health and Welfare School of Medicine, Department of Neurology, Narita, Japan. · Kaiser Permanente Northern California, Neuroscience Department, Redwood City, California, USA. · Department of Clinical Epileptology, Sleep Disorders and Functional Pediatric Neurology, University Hospitals of Lyon; Member of the European Reference Network on Rare and Complex epilepsies, ERN EpiCARE, Lyon, France. · Sigmund Freud Privat Universitat Wien Paris Ringgold standard institution, Department for Epileptology and Clinical Neurophysiology, and General Hospital Hietzing with Neurological Center Rosenhuegel, Department of Neurology, Vienna, Austria. · University of South Florida, Department of Neurology, Tampa, Florida, USA. · Westmead Hospital-Neurology, Wentworthville, New South Wales, Australia. · Rush University Medical Center - Department of Neurological Sciences Section of Epilepsy, Chicago, Illinois, USA. · St. Elizabeth Mercy hospital, - Neurology, Youngstown, Ohio, USA. · Hospital Clínic - Epilepsy Unit, Department of Neurology; Member of the European Reference Network on Rare and Complex epilepsies, ERN EpiCARE, Barcelona, Spain. · Claudio Munari Epilepsy Surgery Centre - Department of Neuroscience, Milan, Italy. · University Hospitals Cleveland Medical Center - Neurology, Cleveland, Ohio, USA. · Epilepsy Center - Neurology, Erlangen, Germany. · Schoen-Klinik Vogtareuth - Neuropediatric Clinic and Clinic for Neurorehabilitation, Epilepsy Center for Children and Adolescents, Vogtareuth, Germany. · University Hospital Cleveland Medical Center - Neurology, Epilepsy Center, Cleveland, Ohio, USA. · University of Florida - Department of Neurology, Gainesville, Florida, USA. · University of Miami, Miller School of Medicine - Department of Neurology, Miami, Florida, USA. · Universitatsklinikum Giessen und Marburg - Standort Marburg Ringgold standard institution - Epilepsy Center, Neurology, Marburg, Hessen, Germany. · University Hospitals - Neurology (Epilepsy), Cleveland Heights, Ohio, USA. · UT Health Memorial Hermann Hospital, Texas Medical Center - Texas Epilepsy, Neurotechnologies and Neuroinformatics Institute, Houston, Texas, USA. · National Neuroscience Institute, and Duke-NUS Medical School, Singapore. · Neuromédica IPS - Epilepsy, Medillin, Colombia. · Kokilaben Dhirubhai Ambani Hospital - Department of Brain and Nervous System, Mumbai, India. · Kobe University Graduate School of Medicine - Division of Neurology, Kobe, Japan. · University Hospitals Case Medical Center/Case Western Reserve University - Neurosurgery, Cleveland, USA. · Ludwig Maximilians University, Munich - Department of Neurology, Epilepsy Center, Munich, Germany. · School of Medicine, Pontificia Universidade Católica do Rio Grande do Sul (PUCRS) - Neurology Service, Porto Alegre Epilepsy Surgery Program, Porto Alegre, Brazil. · Case Medical Center - Pediatrics, Cleveland, Ohio, USA. · Hospital of the Goethe-University Frankfurt am Main - Epilepsy Center Frankfurt Rhine-Main, Frankfurt, Germany. · Rainbow Babies & Children's Hospital, Case Western University School of Medicine - Pediatrics, Cleveland, Ohio, USA. · Northwestern University Feinberg School of Medicine Ringgold standard institution - Neurology, Chicago, Illinois, USA. · Kork - Epilepsy Center, Kehl-Kork, Germany. · UTHSCSA - Neurology, San Antonio and South Texas Comprehensive Epilepsy Center, San Antonio, Texas. · University of Texas Health Science Center - Neurosurgery, Houston, Texas, USA. · National Hospital Organization Shizuoka Institute of Epilepsy and Neurological Disorders, Department of Epileptology, Urushiyama, Japan. · Stichting Epilepsie Instellingen Nederland Ringgold standard institution - Neurology, Hoofddorp, Noord-Holland, The Netherlands. · Beaumont Hospital - Department of Neurology, Dublin, Ireland. · Grenoble-Alpes Hospital and University - Neurology Department and GIN INSERM U-1216, Grenoble, France. ·Epileptic Disord · Pubmed #30782582.

ABSTRACT: This educational review describes the classification of paroxysmal events and a four-dimensional epilepsy classification system. Paroxysmal events are classified as epileptic and non-epileptic paroxysmal events. Non-epileptic events are, in turn, classified as psychogenic and organic paroxysmal events. The following four dimensions are used to classify epileptic paroxysmal events: ictal semiology, the epileptogenic zone, etiology, and comorbidities. Efforts are made to keep these four dimensions as independent as possible. The review also includes 12 educational vignettes and three more detailed case reports classified using the 2017 classification of the ILAE and the four-dimensional epilepsy classification. In addition, a case is described which is classified using the four-dimensional epilepsy classification with different degrees of precision by an emergency department physician, a neurologist, and an epileptologist. [Published with video sequences on www.epilepticdisorders.com].

9 Review Depression in people with epilepsy: How much do Asian colleagues acknowledge it? 2018

Asadi-Pooya, Ali A / Kanemoto, Kousuke / Kwon, Oh-Young / Taniguchi, Go / Dong, Zhou / Chinvarun, Yotin / Yu, Hsiang-Yu / McGonigal, Aileen / Kanner, Andres Miguel / Park, Sung-Pa. ·Neurosciences Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USA. Electronic address: aliasadipooya@yahoo.com. · Neuropsychiatric Department, Aichi Medical University, Nagakute, Aichi, Japan. Electronic address: fwkh2919@mb.infoweb.ne.jp. · Department of Neurology, Gyeonsang National University, College of Medicine, Jinju, South Korea. Electronic address: mnkwon21@hanmail.net. · Department of Neuropsychiatry, University of Tokyo, Japan. Electronic address: taniguchi-jes@umin.ac.jp. · Department of Neurology, West China Hospital, Sichuan University, China. Electronic address: zhoudong66@yahoo.de. · Department of Neurology, Phramongkutklao Hospital and Medical College, Bangkok, Thailand. Electronic address: yotin@yahoo.com. · Department of Neurology, Taipei Veterans General Hospital, Tapiei and National Yang-Ming University, Taiwan. Electronic address: alicehyyu@gmail.com. · Aix Marseille Univ., INSERM, INS, Inst Neurosci Syst, Marseille, France; AP-HM, Hôpital de la Timone, Service de Neurophysiologie Clinique, Marseille, France. Electronic address: aileen.mcgonigal@univ-amu.fr. · University of Miami, Miller School of Medicine, FL, USA. Electronic address: a.kanner@med.miami.edu. · Department of Neurology, Kyungpook National University School of Medicine, Daegu, South Korea. Electronic address: sppark@knu.ac.kr. ·Seizure · Pubmed #29562209.

ABSTRACT: PURPOSE: The purpose of this review was to investigate the prevalence of depression in people with epilepsy (PWE) in different countries in Asia. METHODS: We searched the electronic database PubMed on June 13, 2017 for articles in English that included the following search terms: "epilepsy" AND "depression" AND "country name" for all Asian countries since 1947. Relevant original studies from Asia were included if they reported the prevalence of depression in PWE. Papers studying special populations (e.g., elderly, veterans, etc.) were not included. In addition, experts in epilepsy field were invited from some Asian countries for an in-depth assessment. RESULTS: Six hundred eighty-seven papers were reviewed and 26 related studies were included in this study. Depression is highly prevalent in PWE in different countries in Asia and the prevalence rates are consistent with rates reported in the literature from other countries: overall, about 25% of PWE suffer from depression. CONCLUSION: In Asian countries, as elsewhere, depression is common in PWE. High quality data is scarce in many countries and validated screening tools [e.g., Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)] to appropriately investigate the prevalence of depression in PWE are still lacking in many languages. Considering the high prevalence of depression among PWE, routine and periodic screening of all PWE for early detection and appropriate management of depression would be a reasonable approach.

10 Review Epilepsy as a Network Disorder (2): What can we learn from other network disorders such as dementia and schizophrenia, and what are the implications for translational research? 2018

Scharfman, Helen E / Kanner, Andres M / Friedman, Alon / Blümcke, Ingmar / Crocker, Candice E / Cendes, Fernando / Diaz-Arrastia, Ramon / Förstl, Hans / Fenton, André A / Grace, Anthony A / Palop, Jorge / Morrison, Jason / Nehlig, Astrid / Prasad, Asuri / Wilcox, Karen S / Jette, Nathalie / Pohlmann-Eden, Bernd. ·Departments of Psychiatry, Neurosciences and Physiology, and the Neuroscience Institute, New York University Langone Medical Center, New York, NY 10016, USA. Electronic address: hscharfman@nki.rfmh.org. · University of Miami, Miller School of Medicine, 1120 NW 14th Street, Room #1324, Miami, FL 33136, USA. · Department of Medical Neuroscience, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada; Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada; Department of Physiology and Cell Biology, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel. · Neuropathological Institute, University Hospitals Erlangen, Germany. · Nova Scotia Early Psychosis Program, Department of Psychiatry, Dalhousie University, Halifax, NS, Canada. · Department of Neurology, University of Campinas, 13083-888 Campinas, Sao Paulo, Brazil. · Centre for Neuroscience & Regenerative Medicine, Uniformed Services University of the Health Sciences, 12725 Twinbrook Parkway, Rockville, MD 20852, USA. · Department of Psychiatry, University of Munich, Klinikum rechts der Isar, Ismaninger Strabe 22, D-81675 Munich, Germany. · Centre for Neural Science, New York University, 4 Washington Place, Room 809, New York, NY 10003, USA. · University of Pittsburgh, 456 Langley Hall, 4200 Fifth Avenue, Pittsburgh, PA 15269, USA. · Department of Neurology, Gladstone Institute, 1650 Owens Street, San Francisco, CA 94158-2261, USA. · Department of Psychiatry, Dalhousie University, Halifax, NS, Canada. · INSERM U 1129, Hôpital Necker, Paris, Faculty of Medicine, Strasbourg, France. · Department of Pediatrics, Children's Hospital of Western Ontario, London, ON, Canada. · Department of Pharmacology & Toxicology, Anticonvulsant Drug Development Program, University of Utah, Salt Lake City, UT, USA. · Icahn School of Medicine at Mount Sinai, Department of Neurology, New York, NY, USA; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada. · Brain Repair Center, Life Science Research Institute, Dalhousie University, Room 229, PO Box 15000, Halifax, NS B3H4R2, Canada. Electronic address: B.Pohlmann-Eden@dal.ca. ·Epilepsy Behav · Pubmed #29097123.

ABSTRACT: There is common agreement that many disorders of the central nervous system are 'complex', that is, there are many potential factors that influence the development of the disease, underlying mechanisms, and successful treatment. Most of these disorders, unfortunately, have no cure at the present time, and therapeutic strategies often have debilitating side effects. Interestingly, some of the 'complexities' of one disorder are found in another, and the similarities are often network defects. It seems likely that more discussions of these commonalities could advance our understanding and, therefore, have clinical implications or translational impact. With this in mind, the Fourth International Halifax Epilepsy Conference and Retreat was held as described in the prior paper, and this companion paper focuses on the second half of the meeting. Leaders in various subspecialties of epilepsy research were asked to address aging and dementia or psychosis in people with epilepsy (PWE). Commonalities between autism, depression, aging and dementia, psychosis, and epilepsy were the focus of the presentations and discussion. In the last session, additional experts commented on new conceptualization of translational epilepsy research efforts. Here, the presentations are reviewed, and salient points are highlighted.

11 Review Can Neurochemical Changes of Mood Disorders Explain the Increase Risk of Epilepsy or its Worse Seizure Control? 2017

Kanner, Andres M. ·Department of Neurology, University of Miami, Miller School of Medicine, 1120 NW 14th Street, Room #1324, Miami, FL, 33136, USA. a.kanner@med.miami.edu. ·Neurochem Res · Pubmed #28667464.

ABSTRACT: The existence of a bidirectional relation between mood disorders and epilepsy has been suggested by six population-based studies. Furthermore, three studies have associated a higher risk of treatment-resistant epilepsy with a history of depression preceding the onset of epilepsy. Common pathogenic mechanisms operant in depression and epilepsy may provide a possible explanation of these observations. This article reviews some of the leading pathogenic mechanisms of depression with respect to potential proconvulsant properties that may provide explanations for these phenomena.

12 Review Psychiatric comorbidities in new onset epilepsy: Should they be always investigated? 2017

Kanner, Andres M. ·Department of Neurology, University of Miami, Miller School of Medicine, 1120 NW, 14th Street, Room #1324, Miami, FL 33136, United States. Electronic address: a.kanner@med.miami.edu. ·Seizure · Pubmed #28532711.

ABSTRACT: The new definition of epilepsy establishes that epilepsy is not only a disorder presenting with epileptic seizures but it can be often associated with cognitive and psychiatric comorbidities. In fact, the prevalence of psychiatric comorbidities is relatively high in patients with epilepsy (PWE), as one in three patients will have experienced a psychiatric disorder in the course of their life, with mood and anxiety disorders being the most frequent. Psychiatric comorbidities often precede the onset of the seizure disorder, and affect the life of these patients and the course of the seizure disorder at several levels, including a worse tolerance of pharmacotherapy with antiepileptic drugs (AEDs), in particular the development of iatrogenic psychiatric symptoms from pharmacologic and surgical treatments, an increased mortality risk, a worse quality of life and higher economic burdens of the patient, family and society as a hole. Accordingly, psychiatric comorbidities should be recognized at the time of the initial evaluation of every PWE and their treatment needs to be incorporated within the overall therapeutic plan. This question is addressed in this article.

13 Review Psychiatric comorbidities in epilepsy: Should they be considered in the classification of epileptic disorders? 2016

Kanner, Andres M. ·Department of Neurology, University of Miami, Miller School of Medicine, 1120 NW, 14th Street, Room #1324, Miami, FL 33136, United States. Electronic address: a.kanner@med.miami.edu. ·Epilepsy Behav · Pubmed #27884642.

ABSTRACT: The prevalence of psychiatric comorbidities is relatively high in people with epilepsy (PWE), as one in three patients will have experienced a psychiatric disorder in the course of their life. The new definition of epilepsy recognizes these comorbidities as part of the seizure disorder, which need to be recognized and treated together with the actual epileptic seizures. Psychiatric comorbidities have a complex relation with epilepsy, being associated with a negative course of the seizure disorder, worse tolerance of pharmacotherapy with AEDs, development of iatrogenic psychiatric complications from pharmacologic and surgical treatments, and increased mortality risks. Given their negative impact at several levels of the lives of PWE, should psychiatric comorbidities be included in a classification of the epilepsies? This question is addressed in this article. This article is part of a Special Issue entitled "The new approach to classification: Rethinking cognition and behavior in epilepsy".

14 Review Psychosis of epilepsy: a multifaceted neuropsychiatric disorder. 2016

Kanner, Andres M / Rivas-Grajales, Ana Maria. ·1Department of Neurology,Comprehensive Epilepsy Centerand Division of Epilepsy,University of Miami,Miller School of Medicine,Miami,Florida,USA. · 2Institute of Cognitive Neuroscience,University College,London,UK. ·CNS Spectr · Pubmed #27322691.

ABSTRACT: Psychosis of epilepsy (POE) is a term applied to a group of psychotic disorders with a distinct phenomenology in which potential etiopathogenic mechanisms are believed to be closely related to a seizure disorder. POE can present as interictal psychotic episodes, which may often differ semiologically from primary schizophrenic disorder. They may present as ictal or postictal psychotic episodes and may be the expression of an iatrogenic process to pharmacologic and/or surgical interventions.Epilepsy and POE have a complex and bidirectional relation, as not only are patients with epilepsy at greater risk of developing a psychotic disorder, but patients with a primary psychotic disorder are also at greater risk of developing epilepsy. The prevalence of POE is more than 7 times higher than the frequency of primary schizophreniform disorders in the general population. While POE has been associated with focal epilepsy of temporal and frontal lobe origin, its etiology and pathophysiology of POE have yet to be established.The treatment of all forms of POE, with the exception of ictal psychotic episodes, requires the use of antipsychotic drugs, preferably the atypical antipsychotic agents with a very low or negligible potential to lower the seizure threshold (eg, risperidone, apiprazole), starting at a low dose with stepwise increments.

15 Review Most antidepressant drugs are safe for patients with epilepsy at therapeutic doses: A review of the evidence. 2016

Kanner, Andres M. ·Department of Neurology, University of Miami, Miller School of Medicine, 1120 NW, 14th Street, Room #1324, Miami, FL 33136, United States. Electronic address: a.kanner@med.miami.edu. ·Epilepsy Behav · Pubmed #27236241.

ABSTRACT: For a long time, there has been a misconception that all antidepressant drugs have proconvulsant effects. Yet, antidepressants of the selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) families have been not only shown to be safe when used in patients with epilepsy (PWE) but have been found to display antiepileptic properties in animal models of epilepsy. In humans randomized to SSRIs vs. a placebo for the treatment of primary major depressive episodes, the incidence of epileptic seizures was significantly lower among those treated with the antidepressants. On the other hand, SSRIs and SNRIs can display proconvulsant properties at toxic doses. This article reviews the preclinical and clinical data of antiepileptic and proconvulsant properties of these drugs and addresses special considerations to take when prescribing them for PWE.

16 Review Management of psychiatric and neurological comorbidities in epilepsy. 2016

Kanner, Andres M. ·Department of Neurology, University of Miami, Miller School of Medicine, 14th Street, 1120 NW, Miami, 33136 Florida, USA. ·Nat Rev Neurol · Pubmed #26782334.

ABSTRACT: The treatment of epileptic seizure disorders is not restricted to the achievement of seizure-freedom, but must also include the management of comorbid medical, neurological, psychiatric and cognitive comorbidities. Psychiatric and neurological comorbidities are relatively common and often co-exist in people with epilepsy (PWE). For example, depression and anxiety disorders are the most common psychiatric comorbidities in PWE, and they are particularly common in PWE who also have a neurological comorbidity, such as migraine, stroke, traumatic brain injury or dementia. Moreover, psychiatric and neurological comorbodities often have a more severe impact on the quality of life in patients with treatment-resistant focal epilepsy than do the actual seizures. Epilepsy and psychiatric and neurological comorbidities have a complex relationship, which has a direct bearing on the management of both seizures and the comorbidities: the comorbidities have to be factored into the selection of antiepileptic drugs, and the susceptibility to seizures has to be considered when choosing the drugs to treat comorbidities. The aim of this Review is to highlight the complex relationship between epilepsy and common psychiatric and neurological comorbidities, and provide an overview of how treatment strategies for epilepsy can positively and negatively affect these comorbidities and vice versa.

17 Review Delivery of epilepsy care to adults with intellectual and developmental disabilities. 2015

Devinsky, Orrin / Asato, Miya / Camfield, Peter / Geller, Eric / Kanner, Andres M / Keller, Seth / Kerr, Michael / Kossoff, Eric H / Lau, Heather / Kothare, Sanjeev / Singh, Baldev K / Wirrell, Elaine. ·From New York University School of Medicine (O.D., H.L., S.K.), New York · Children's Hospital of Pittsburgh of UPMC (M.A.), PA · IWK Heath Centre and Dalhousie University (P.C.), Halifax, Canada · Saint Barnabas Medical Center (E.G.), Livingston, NJ · University of Miami Miller School of Medicine (A.M.K.), FL · Advocare Neurology of South Jersey (S.K.), Lumberton, NJ · Welsh Centre for Learning Disabilities (M.K.), Cardiff University, Cathays, Cardiff, UK · Johns Hopkins Hospital (E.H.K.), Baltimore, MD · New York Medical College (B.K.S.), New York · and Mayo Clinic Hospital (E.W.), Rochester, MN. ·Neurology · Pubmed #26423430.

ABSTRACT: Epilepsy is common in people with intellectual and developmental disabilities (IDD). In adulthood, patients with IDD and epilepsy (IDD-E) have neurologic, psychiatric, medical, and social challenges compounded by fragmented and limited care. With increasing neurologic disability, there is a higher frequency of epilepsy, especially symptomatic generalized and treatment-resistant epilepsies. The causes of IDD-E are increasingly recognized to be genetic based on chromosomal microarray analysis to identify copy number variants, gene panels (epilepsy, autism spectrum disorder, intellectual disability), and whole-exome sequencing. A specific genetic diagnosis may guide care by pointing to comorbid disorders and best therapy. Therapy to control seizures should be individualized, with drug selection based on seizure types, epilepsy syndrome, concomitant medications, and comorbid disorders. There are limited comparative antiepileptic drug data in the IDD-E population. Vagus nerve and responsive neural stimulation therapies and resective surgery should be considered. Among the many comorbid disorders that affect patients with IDD-E, psychiatric and sleep disorders are common but often unrecognized and typically not treated. Transition from holistic and coordinated pediatric to adult care is often a vulnerable period. Communication among adult health care providers is complex but essential to ensure best care when these patients are seen in outpatient, emergency room, and inpatient settings. We propose specific recommendations for minimum care standards for people with IDD-E.

18 Review The relevance of neuropsychiatric symptoms and cognitive problems in new-onset epilepsy - Current knowledge and understanding. 2015

Pohlmann-Eden, B / Aldenkamp, A / Baker, G A / Brandt, C / Cendes, F / Coras, R / Crocker, C E / Helmstaedter, C / Jones-Gotman, M / Kanner, A M / Mazarati, A / Mula, M / Smith, M L / Omisade, A / Tellez-Zenteno, J / Hermann, B P. ·Division of Neurology, Dalhousie University of Halifax, Canada; Brain Repair Center, Dalhousie University of Halifax, Canada. Electronic address: B.Pohlmann-Eden@dal.ca. · Epilepsiecentrum Kempenhaeghe, The Netherlands. · Division of Neurosciences, University of Liverpool, United Kingdom. · Bethel Epilepsy Center, Mara Hospital, Bielefeld, Germany. · Department of Neurology, University of Campinas, São Paulo, Brazil. · Department of Neuropathology, University of Erlangen, Germany. · Division of Neurology, Dalhousie University of Halifax, Canada. · Department of Epileptology, University of Bonn, Germany. · McGill University, Montreal Neurological Institute, Montreal, Canada. · Epilepsy Center, University of Miami, Miller School of Medicine, USA. · Children's Discovery and Innovation Institute, D. Geffen School of Medicine at UCLA, Los Angeles, USA. · Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals NHS Foundation Trust and Institute of Medical and Biomedical Sciences St. George's University of London, United Kingdom. · Department of Psychology, University of Toronto, Canada. · Epilepsy Program Royal University Hospital, Saskatoon, Canada. · Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, USA. ·Epilepsy Behav · Pubmed #26291774.

ABSTRACT: Neurobehavioral and cognition problems are highly prevalent in epilepsy, but most research studies to date have not adequately addressed the precise nature of the relationship between these comorbidities and seizures. To address this complex issue and to facilitate collaborative, innovative research in the rising field of neurobehavioral comorbidities and cognition disturbances in new-onset epilepsy, international epilepsy experts met at the 3rd Halifax International Epilepsy Conference & Retreat at White Point, South Shore, Nova Scotia, Canada from September 18 to 20, 2014. This Conference Proceedings provides a summary of the conference proceedings. Specifically, the following topics are discussed: (i) role of comorbidities in epilepsy diagnosis and management, (ii) role of antiepileptic medications in understanding the relationship between epilepsy and neurobehavioral and cognition problems, and (iii) animal data and diagnostic approaches. Evidence to date, though limited, strongly suggests a bidirectional relationship between epilepsy and cognitive and psychiatric comorbidities. In fact, it is likely that seizures and neurobehavioral problems represent different symptoms of a common etiology or network-wide disturbance. As a reflection of this shared network, psychiatric comorbidities and/or cognition problems may actually precede the seizure occurrence and likely get often missed if not screened.

19 Review Third International Congress on Epilepsy, Brain, and Mind: Part 2. 2015

Rektor, Ivan / Schachter, Steven C / Arya, Ravindra / Arzy, Shahar / Braakman, Hilde / Brodie, Martin J / Brugger, Peter / Chang, Bernard S / Guekht, Alla / Hermann, Bruce / Hesdorffer, Dale C / Jones-Gotman, Marilyn / Kanner, Andres M / Garcia-Larrea, Luis / Mareš, Pavel / Mula, Marco / Neufeld, Miri / Risse, Gail L / Ryvlin, Philippe / Seeck, Margitta / Tomson, Torbjörn / Korczyn, Amos D. ·Masaryk University, Brno Epilepsy Center, St. Anne's Hospital and School of Medicine and Central European Institute of Technology (CEITEC), Brno, Czech Republic. · Consortia for Improving Medicine with Innovation and Technology, Harvard Medical School, Boston, MA, USA. Electronic address: sschacht@bidmc.harvard.edu. · Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. · Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. · Academic Center for Epileptology, Kempenhaeghe & Maastricht UMC, Sterkselseweg 65, 5591 VE Heeze, The Netherlands. · Epilepsy Unit, Western Infirmary, Glasgow, Scotland, UK. · Neuropsychology Unit, Department of Neurology, University Hospital Zürich, Zurich, Switzerland. · Departments of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA. · Russian National Research Medical University, Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia. · Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. · Gertrude H. Sergievsky Center and Department of Epidemiology, Columbia University, NY, USA. · Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada. · Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA. · NeuroPain Lab, Centre for Neuroscience of Lyon, Inserm U1028, Hôpital Neurologique, 59Bd Pinel 69003 Lyon, France. · Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic. · Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital & Institute of Medical and Biomedical Sciences, St George's University of London, London, UK. · EEG and Epilepsy Unit, Department of Neurology, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel. · Minnesota Epilepsy Group, St. Paul, MN, USA. · Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland; TIGER, Lyon's Neuroscience Research Center, INSERM U1028, CNRS5292 Lyon, France. · Neurology Service, Hòpitaux Universitaires de Genève, Genève, Switzerland. · Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. · Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel. ·Epilepsy Behav · Pubmed #26264466.

ABSTRACT: Epilepsy is both a disease of the brain and the mind. Here, we present the second of two papers with extended summaries of selected presentations of the Third International Congress on Epilepsy, Brain and Mind (April 3-5, 2014; Brno, Czech Republic). Humanistic, biologic, and therapeutic aspects of epilepsy, particularly those related to the mind, were discussed. The extended summaries provide current overviews of epilepsy, cognitive impairment, and treatment, including brain functional connectivity and functional organization; juvenile myoclonic epilepsy; cognitive problems in newly diagnosed epilepsy; SUDEP including studies on prevention and involvement of the serotoninergic system; aggression and antiepileptic drugs; body, mind, and brain, including pain, orientation, the "self-location", Gourmand syndrome, and obesity; euphoria, obsessions, and compulsions; and circumstantiality and psychiatric comorbidities.

20 Review Is depression associated with an increased risk of treatment-resistant epilepsy? Research strategies to investigate this question. 2014

Kanner, Andres M. ·Department of Neurology, University of Miami, Miller School of Medicine, USA. Electronic address: a.kanner@med.miami.edu. ·Epilepsy Behav · Pubmed #25260238.

ABSTRACT: Persons with epilepsy (PWE) have a higher risk of developing depressive disorders (DDs), and people with primary DD have an increased risk of developing epilepsy. Furthermore, a lifetime history of DD has been associated with a worse response of the seizure disorder to pharmacotherapy and epilepsy surgery. The first part of this article reviews the literature of this problem with the intention of highlighting the neurobiologic pathogenic mechanisms operant in DD with a potential to facilitate the epileptogenic process and/or cortical hyperexcitability in humans and experimental animal studies of depression. They include the following: (i) a hyperactive hypothalamic-pituitary-adrenal axis and the associated structural and functional abnormalities of limbic structures, (ii) increased glutamatergic activity and decreased GABAergic and serotonergic activity, and (iii) immunologic disturbances. In the second part of this article, we suggest research strategies to test the hypothesis of whether depression worsens the course of epilepsy and identify the pathogenic mechanisms operant in this process.

21 Review Biomarkers of epileptogenesis: psychiatric comorbidities (?). 2014

Kanner, Andres M / Mazarati, Andrey / Koepp, Matthias. ·Department of Neurology, University of Miami, Miller School of Medicine, 1120 NW, 14th Street, Room 1324, Miami, FL, 33136, USA, a.kanner@med.miami.edu. ·Neurotherapeutics · Pubmed #24719199.

ABSTRACT: The last decade has witnessed a significant shift on our understanding of the relationship between psychiatric disorders and epilepsy. While traditionally psychiatric disorders were considered as a complication of the underlying seizure disorder, new epidemiologic data, supported by clinical and experimental research, have suggested the existence of a bidirectional relation between the two types of conditions: not only are patients with epilepsy at greater risk of experiencing a psychiatric disorder, but patients with primary psychiatric disorders are at greater risk of developing epilepsy. Do these data suggest that some of the pathogenic mechanisms operant in psychiatric comorbidities play a role in epileptogenesis? The aim of this article is to review the epidemiologic data that demonstrate that primary psychiatric disorders are more frequent in people who develop epilepsy, before the onset of the seizure disorder than among controls. The next question looks at the available data of pathogenic mechanisms of primary mood disorders and their potential for facilitating the development and/or exacerbation in the severity of epileptic seizures. Finally, we review data derived from experimental studies in animal models of depression and epilepsy that support a potential role of pathogenic mechanisms of mood disorders in the development of epileptic seizures and epileptogenesis. The data presented in this article do not yet establish conclusive evidence of a pathogenic role of psychiatric comorbidities in epileptogenesis, but raise important research questions that need to be investigated in experimental, clinical, and population-based epidemiologic research studies.

22 Review Issues related to symptomatic and disease-modifying treatments affecting cognitive and neuropsychiatric comorbidities of epilepsy. 2013

Brooks-Kayal, Amy R / Bath, Kevin G / Berg, Anne T / Galanopoulou, Aristea S / Holmes, Gregory L / Jensen, Frances E / Kanner, Andres M / O'Brien, Terence J / Whittemore, Vicky H / Winawer, Melodie R / Patel, Manisha / Scharfman, Helen E. ·Departments of Pediatrics, Neurology and Pharmaceutical Sciences, University of Colorado Schools of Medicine and Pharmacy, Children's Hospital Colorado, Aurora, Colorado, USA. Amy.brooks-kayal@childrenscolorado.org ·Epilepsia · Pubmed #23909853.

ABSTRACT: Many symptoms of neurologic or psychiatric illness--such as cognitive impairment, depression, anxiety, attention deficits, and migraine--occur more frequently in people with epilepsy than in the general population. These diverse comorbidities present an underappreciated problem for people with epilepsy and their caregivers because they decrease quality of life, complicate treatment, and increase mortality. In fact, it has been suggested that comorbidities can have a greater effect on quality of life in people with epilepsy than the seizures themselves. There is increasing recognition of the frequency and impact of cognitive and behavioral comorbidities of epilepsy, highlighted in the 2012 Institute of Medicine report on epilepsy. Comorbidities have also been acknowledged, as a National Institutes of Health (NIH) Benchmark area for research in epilepsy. However, relatively little progress has been made in developing new therapies directed specifically at comorbidities. On the other hand, there have been many advances in understanding underlying mechanisms. These advances have made it possible to identify novel targets for therapy and prevention. As part of the International League Against Epilepsy/American Epilepsy Society workshop on preclinical therapy development for epilepsy, our working group considered the current state of understanding related to terminology, models, and strategies for therapy development for the comorbidities of epilepsy. Herein we summarize our findings and suggest ways to accelerate development of new therapies. We also consider important issues to improve research including those related to methodology, nonpharmacologic therapies, biomarkers, and infrastructure.

23 Review Epilepsy, cognition, and neuropsychiatry (Epilepsy, Brain, and Mind, part 2). 2013

Korczyn, Amos D / Schachter, Steven C / Brodie, Martin J / Dalal, Sarang S / Engel, Jerome / Guekht, Alla / Hecimovic, Hrvoje / Jerbi, Karim / Kanner, Andres M / Johannessen Landmark, Cecilie / Mares, Pavel / Marusic, Petr / Meletti, Stefano / Mula, Marco / Patsalos, Philip N / Reuber, Markus / Ryvlin, Philippe / Štillová, Klára / Tuchman, Roberto / Rektor, Ivan. ·Sackler School of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel. ·Epilepsy Behav · Pubmed #23764496.

ABSTRACT: Epilepsy is, of course, not one disease but rather a huge number of disorders that can present with seizures. In common, they all reflect brain dysfunction. Moreover, they can affect the mind and, of course, behavior. While animals too may suffer from epilepsy, as far as we know, the electrical discharges are less likely to affect the mind and behavior, which is not surprising. While the epileptic seizures themselves are episodic, the mental and behavioral changes continue, in many cases, interictally. The episodic mental and behavioral manifestations are more dramatic, while the interictal ones are easier to study with anatomical and functional studies. The following extended summaries complement those presented in Part 1.

24 Review Treatment of postsurgical psychiatric complications. 2013

Koch-Stoecker, Steffi / Schmitz, Bettina / Kanner, Andres M. ·Epilepsy Center Mara, Bielefeld, Germany. steffi.koch-stoecker@evkb.de ·Epilepsia · Pubmed #23458466.

ABSTRACT: We describe the physical, psychological, and social complications and adaptation demands after epilepsy surgery and the risks of the development of psychiatric disorders when adequate stress processing fails. Practical strategies that can be followed in the prevention and treatment of postsurgical psychiatric complications are reviewed. The postoperative period is divided in three phases: (1) the early postoperative phase of stress processing until discharge from hospital; (2) the coping phase during the first months after discharge; and (3) the reorientation phase. The early postoperative course is often dominated by physical problems that hamper success in convalescence. They may initiate early psychiatric disturbances especially in patients with preoperative psychiatric comorbidity. The second phase after discharge from hospital is the typical time in which various psychiatric disorders may develop (either de novo or exacerbations of known disorders). At this time it is mandatory to keep in contact with patients, to start psychiatric treatments if necessary, and to assess for suicidal risk. The course of the third phase of reorientation depends on seizure outcome and on psychiatric state. Seizure-free persons without psychiatric comorbidities start to forget their epilepsy; those with less successful outcome conditions may need further support, especially for vocational integration. Epilepsy surgery brings about an overall strong improvement of psychiatric morbidity and quality of patients' life. Nevertheless, the first postoperative year is a fragile period that includes multiple physical, psychological, and social adaptation tasks. Patients with a history of psychiatric disorders are at a special risk of failing to cope with those health-related demands, but also for nonpsychiatric patients the months after epilepsy surgery are often stressful and exhausting. Professional help must be available during the postoperative coping time.

25 Review The treatment of depressive disorders in epilepsy: what all neurologists should know. 2013

Kanner, Andres M. ·Comprehensive Epilepsy Program and Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA. a.kanner@med.miami.edu ·Epilepsia · Pubmed #23458461.

ABSTRACT: One of every three patients with epilepsy (PWE) will experience a depressive disorder in the course of their life, often associated with anxiety symptoms or a full blown anxiety disorder. Clearly, the high prevalence of these psychiatric comorbidities calls for their early identification and management. This article provides practical strategies in the management of depressive episodes in PWE. Contrary to long-held beliefs, the use of antidepressant drugs are safe in PWE when used at therapeutic doses. Antidepressant drugs of the selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) families are the first line of therapy in depressive disorders, and failure to achieve complete symptom remission after a trial of an SSRI or SNRI at optimal doses should be followed by a second trial with a drug from the other antidepressant family. In developing countries, antidepressant drugs of these two antidepressant families are not always available, and tricyclic antidepressants (TCAs) are the drugs of choice. Although there are no differences in efficacy among the three families of antidepressants, TCAs have a lower tolerability and higher toxicity, with greater mortality risk associated with cardiotoxic effects in overdoses. Cognitive behavior therapy is another treatment modality that has been shown to be effective in the treatment of depressive disorders in patients with and without epilepsy. Its use should be considered together with pharmacotherapy or by itself.

Next