Patterns and frequency of the treatment of depression in persons with epilepsy.

Objective: Though depression is common in persons with epilepsy, it often remains undiagnosed and/or untreated. The current study aimed to determine the proportion of persons with epilepsy receiving depression-related treatment and to characterize the type of treatment received.

Methods: Persons with epilepsy (n=185) from the only epilepsy clinic in a city of 1.2 million people completed questionnaires and the gold-standard Structured Clinical Interview for DSM Disorders (SCID) to assess current and past depression. Treatment for depression (pharmacological and nonpharmacological) was ascertained through patient self-report and chart review.

Results: Of those with current depression (n=27), the majority (70.3%) were not on any depression-related treatment. In persons with current depression, nonpharmacological management was the most common treatment method, followed by treatment with psychotropic medications such as selective serotonin reuptake inhibitors. More individuals with a past history of depression but without a current episode (n=43) were treated (37.2%); it was more common for these individuals to be treated with pharmacological measures. After using an algorithm that adjusts the treated prevalence for those who are successfully treated, the adjusted proportion of depression treatment was 53.1%.

Conclusions: The proportion of people treated for current depression in this cohort was very low. Future studies should investigate barriers to treatment and how depression treatment can be optimized for those with epilepsy.