Psychotropic medication use in patients with epilepsy: Effect on seizure frequency

Physicians ave often reluctant to use psychotropic medications in epilepsy patients with psychiatric disorders because of concern over the potential r isk for lowering seizure threshold. This study assesses retrospectively the impact of psychotropic medications on seizure frequency in 57 patients see n consecutively at an epilepsy center. During psychotropic drug therapy, se izure frequency decreased in 33% of patients, was unchanged in 44%, and inc reased in 23%. Mean seizure frequency was not statistically different betwe en pretreatment and treatment periods (t = 0.23, df=56). Simultaneous adjus tments in antiepileptic drug regimen could not account for the findings. Re sults support the position that psychotropic medications, introduced slowly in low to moderate doses, can be safely used in epilepsy patients with com orbid psychiatric pathology during the regular course of clinical care.