Jun 15th 2023
Epileptic psychosis refers to the range of psychotic symptoms that can appear in people with epilepsy. In some cases, a patient may have episodes of psychosis that occur around the same time as epileptic seizure activity. In other instances, a patient may develop chronic psychosis symptoms that mirror schizophrenia .
While the exact prevalence of epileptic psychosis is unclear, studies suggest that around 3% to 7% of those with epilepsy will develop schizophrenia, compared to just 1% of the general population. This suggests that epilepsy may increase the risk for psychotic symptoms, such as those seen in patients with schizophrenia .
While the data is not entirely conclusive, there is evidence that psychotic symptoms seem to be more likely among those with temporal lobe epilepsy when compared to idiopathic generalized epilepsy .
While epileptic psychosis can resemble psychosis seen in schizophrenia, not every case of epileptic psychosis looks the same. In fact, there can be several types of psychosis in patients with epilepsy, based upon the timing of psychosis in relation to seizure activity :
Psychosis in epilepsy patients requires early treatment and intervention, because if psychosis is untreated, it can persist. Put another way, psychotic episodes beget psychotic episodes, meaning that it’s important to intervene at the first sign of psychosis, to reduce the risk of relapse or recurrent psychotic episodes .
Patients with epileptic psychosis can also experience declines in functioning, making it difficult to care for themselves. This makes it critical for individuals with this condition to receive a range of psychosocial services to keep them linked to support .
Treatment of epileptic psychosis requires careful monitoring and interventions that are adapted to a patient’s unique needs, based upon their clinical presentation. There is limited research on the best treatment for psychosis of epilepsy, so the condition is generally treated utilizing the same methods used in treatment of psychosis outside of epilepsy .
Both first and second-generation antipsychotics can be used to treat psychosis, but second-generation antipsychotics are believed to come with fewer side effects. Some research suggests that olanzapine, risperidone, and quetiapine are the best choices for treating first-episode psychosis, including that which occurs with epilepsy.
However, one important consideration is the fact that some antipsychotic drugs may cause seizures. Because of this risk factor, risperidone is often the first line of treatment used for epileptic psychosis .
Beyond medication, patients living with epileptic psychosis should receive integrated treatment from a multidisciplinary team. This team usually consists of a neurologist, a psychiatrist, and a social worker.
If you have epilepsy and begin to experience symptoms of psychosis, either during, after, or between episodes, it’s important to reach out for treatment. Experiencing psychotic symptoms can be distressing, but treatment can help you to manage your symptoms.
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