Depression in older adults with epilepsy: Pathophysiology and management considerations

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior Pub Date : 2025-09-01 DOI:10.1016/j.yebeh.2025.110692

Michael Sadek , Zeina Chemali , Rani A. Sarkis

{"title":"Depression in older adults with epilepsy: Pathophysiology and management considerations","authors":"Michael Sadek , Zeina Chemali , Rani A. Sarkis","doi":"10.1016/j.yebeh.2025.110692","DOIUrl":null,"url":null,"abstract":"<div><div>Older adults with epilepsy are at an increased risk for comorbid depression, which worsens their quality of life. This review aims to outline the pathophysiological mechanisms thought to underly the comorbidity of depression in older adults with epilepsy and propose clinical and pharmacological considerations for the holistic management of depression in this population. Indeed, there is a wide range of reported prevalence of depression in older adults with epilepsy, yet these are likely underestimates since depression is underdiagnosed in this population. Age-related drivers of depression include biological and social risk factors such as neurodegenerative changes, inflammation, cerebrovascular dysfunction, social isolation, stigma, and poor health status. Additional contributors related to epilepsy include the impact of seizures, the effects of anti-seizure medications, and the role of sleep-disordered breathing. Therefore, the management of depression in older adults with epilepsy is centered on screening for depression and obstructive sleep apnea, careful choice of anti-seizure medications and anti-depressants, and the provision of social and psychological support.</div></div>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"172 ","pages":"Article 110692"},"PeriodicalIF":2.3000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Epilepsy & Behavior","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1525505025004329","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BEHAVIORAL SCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Older adults with epilepsy are at an increased risk for comorbid depression, which worsens their quality of life. This review aims to outline the pathophysiological mechanisms thought to underly the comorbidity of depression in older adults with epilepsy and propose clinical and pharmacological considerations for the holistic management of depression in this population. Indeed, there is a wide range of reported prevalence of depression in older adults with epilepsy, yet these are likely underestimates since depression is underdiagnosed in this population. Age-related drivers of depression include biological and social risk factors such as neurodegenerative changes, inflammation, cerebrovascular dysfunction, social isolation, stigma, and poor health status. Additional contributors related to epilepsy include the impact of seizures, the effects of anti-seizure medications, and the role of sleep-disordered breathing. Therefore, the management of depression in older adults with epilepsy is centered on screening for depression and obstructive sleep apnea, careful choice of anti-seizure medications and anti-depressants, and the provision of social and psychological support.

查看原文本刊更多论文

老年癫痫患者的抑郁：病理生理学和管理考虑

老年癫痫患者患共病性抑郁症的风险增加，这使他们的生活质量恶化。本综述旨在概述老年癫痫患者抑郁症共病的病理生理机制，并提出老年癫痫患者抑郁症整体治疗的临床和药理学考虑。事实上，在老年癫痫患者中有广泛的抑郁症患病率报告，但这些可能被低估了，因为抑郁症在这一人群中未得到充分诊断。与年龄相关的抑郁症驱动因素包括生物和社会风险因素，如神经退行性改变、炎症、脑血管功能障碍、社会孤立、耻辱和健康状况不佳。与癫痫有关的其他因素包括癫痫发作的影响、抗癫痫药物的作用以及睡眠呼吸障碍的作用。因此，老年癫痫患者的抑郁管理主要集中在筛查抑郁和阻塞性睡眠呼吸暂停，谨慎选择抗癫痫药物和抗抑郁药物，并提供社会和心理支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.