Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 299, Issue -, Pages 1-5Publisher
ELSEVIER
DOI: 10.1016/j.jad.2021.11.046
Keywords
Depression; Epilepsy; Antidepressants; Comorbid
Categories
Funding
- Lundbeck foundation [R279-2018-1145]
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The study confirmed a decreased response to antidepressants in patients with depression and comorbid epilepsy, especially among younger and unemployed patients. This emphasizes the importance of close monitoring and psychological support for these patients.
Objective: In a nation-wide population-based longitudinal register linkage study to investigate long-term response to antidepressants in patients with depression with and without comorbid epilepsy. Methods: We used Danish nation-wide population-based longitudinal register linkage to identify 1487 patients with depression and comorbid epilepsy and 71,163 patients with depression without comorbid epilepsy during a study period from 1995 to 2017. Response was defined as continuous monotherapy with an antidepressant drug without switch to or add-on of another antidepressant drug, an antipsychotic drug or lithium or hospitalization during an up to ten-year follow-up period. We calculated standardized absolute risks and differences thereof with respect to age, gender, socioeconomic status and comorbidity with other physical disorders than epilepsy. Results: In patients with depression, response to antidepressants was decreased with versus without comorbid epilepsy during the ten-year follow-up period. One year after start of antidepressant treatment the proportion of responders was 12% (CI: 10%-14%) lower in patients with versus without comorbid epilepsy in the standardized population. Response to antidepressants were specifically decreased among younger and unemployed patients with depression and comorbid epilepsy. Limitations: We did not include sub-analyses according to subtypes of epilepsy. Conclusions: Response to antidepressants was decreased in patients with comorbid epilepsy versus without comorbid epilepsy at all time points during a ten-year follow-up period. The study highlights the need for closely clinical monitoring and psychological support for patients with depression and comorbid epilepsy and emphasize the need for further long-term studies of effect of interventions.
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