Abstracts

Rationale: It is well known that epilepsy patients show an increased risk of schizophrenia and schizophrenia-like psychosis. However, the treatment of mental disorders in epilepsy patients is not yet established. Therefore, we retrospectively evaluated the effectiveness of atypical antipsychotic treatment for epilepsy patients with psychiatric disorder, who were admitted to the epilepsy ward of National Center of Neurology and Psychiatry for alleviating their mental symptoms. Methods: Patients hospitalized between April 1, 2006 and March 31, 2007 were investigated. Among them, 15 epilepsy patients (12 men and 3 women) who were hospitalized for the treatment of psychotic symptoms during the interictal phase were studied. The average age of the patients was 39.9 ± 9.9 (mean ± SD) years. A retrospective review of the clinical charts was performed. Results: The epilepsy patients with psychiatric disorders were classified into 5 groups: (a) psychosis (6 patients), (b) dysphoria and violence (5 patients), (c) anxiety and depression (1 patient), (d) manic state (1 patient), and (e) undifferentiated (2 patients). Of these epilepsy patients, 11 patients were treated with risperidone; 9 patients, with olanzapine. All patients receiving atypical antipsychotic treatment (7 with risperidone, 8 with olanzapine) demonstrated an improvement in psychiatric function, and all patients, except 1 was discharged from the inpatient care. Extrapyramidal side effects were observed in 1 patient who was treated with risperidone, due to which the medication was discontinued. The treatment was interrupted or another antiepileptic drug was included because of the aggravation of seizure in 2 patients who were treated with olanzapine. 9 patients, who were resistant to treatment with conventional antipsychotics, were treated with atypical antipsychotic drugs, and they were discharged after clinical improvement was observed. Conclusions: 1. Risperidone and olanzapine are both effective in treating psychosis in patients with epilepsy. 2. While olanzapine is more effective than risperidone, some patients treated with olanzapine showed exacerbation of epileptic seizures. 3. Risperidone and olanzapine are both beneficial in treating psychiatric symptoms in epilepsy patients and should be used with caution.