Article Text
Abstract
The psychoses of epilepsy can be classified according to their temporal relationship with seizures, namely as ictal, postictal and interictal psychosis. Interictal psychosis is the most common and may resemble schizophrenia. They can be challenging to diagnose and to manage, especially given the perception that some antipsychotic drugs may exacerbate seizures, while some antiepileptic medications may worsen psychosis. The current uncertainty around their best management means that some patients may not receive appropriate care. We propose a practical stepwise approach to managing psychosis in patients with epilepsy, summarising the key clinical features. We provide a framework for diagnosis, investigation and management of psychosis in the acute and long term. We also summarise the available evidence on the risk of psychosis with current antiepileptic drugs and the risk of seizures with antipsychotic drugs.
- epilepsy
- psychosis
Statistics from Altmetric.com
Footnotes
Contributors JS is the coauthor along with MM, who is the first author. MM was responsible for drafting the review and final approval of the published version. JS contributed to the writing and content of the final review. AGM provided critical appraisal of the review and overall guidance.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Commissioned; externally peer reviewed. This paper was reviewed by Alan Carson, Edinburgh, UK, and Rajiv Mohanraj, Manchester, UK.
Read the full text or download the PDF:
Other content recommended for you
- Bilateral volume reduction in posterior hippocampus in psychosis of epilepsy
- Systematic review of structural and functional brain alterations in psychosis of epilepsy
- Individual vulnerabilities to psychosis after antiepileptic drug administration
- The psychoses of epilepsy
- Schizophrenia-like psychosis arising de novo following a temporal lobectomy: timing and risk factors
- Risk for schizophrenia and schizophrenia-like psychosis among patients with epilepsy: population based cohort study
- The psychoses of epilepsy
- Psychosis and temporal lobe epilepsy-role of electroconvulsive therapy
- Impact of surgical intervention on seizure and psychiatric symptoms in patients with temporal lobe epilepsy
- Non-convulsive status epilepticus: mimics and chameleons