Treatment of depression in patients with temporal lobe epilepsy: A pilot study of cognitive behavioral therapy vs. selective serotonin reuptake inhibitors |
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| Institution: | 1. Neuropsychiatry Unit, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico;2. Epilepsy Clinic, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico;3. Postgraduate Division, Universidad Nacional Autónoma de México, Mexico City, Mexico;1. Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA;2. The University of Texas Health Science at San Antonio, San Antonio, TX, USA;3. McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA;4. Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA;5. Consultant and Yale University, 2207 Bancroft St., Houston, TX 77027, United States of America;6. IDEAS 2.0 Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT, USA;1. Emory University, Atlanta, GA 30322, United States of America;2. University of Michigan, Ann Arbor, MI 48109, United States of America;3. University of Washington, Seattle, WA 98195, United States of America;1. Department of Psychiatry, Case Western Reserve University School of Medicine, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, United States;2. Department of Neurology, Case Western Reserve University School of Medicine, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, United States;3. Department of Neurology, New York University School of Medicine, New York, NY, United States;4. Department of Population Health, New York University School of Medicine, NY, New York, United States;5. Center for Managing Chronic Disease, University of Michigan, Ann Arbor, MI, United States;6. Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States;7. Department of Electrical Engineering and Computer Science, School of Medicine, Case Western Reserve University, Cleveland, OH, United States;8. Emory University Rollins School of Public Health, Atlanta, GA, United States;9. Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, NH, United States;1. Epilepsy Unit, Neurological Institute C. Besta IRCCS Foundation, Via Celoria 11, 20133 Milan, Italy;2. Neurology Department, ASL AL, Casale Monferrato, Italy;3. Division of Clinical Neurophysiology and Epilepsy Center, IRCCS Ospedale San Martino, Largo R. Benzi 10, 16132 Genova, Italy |
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| Abstract: | There is a high prevalence of depression in patients with epilepsy, which negatively impacts their quality of life (QOL) and seizure control. Currently, the first-line of treatment for depression in patients with epilepsy is based on selective serotonin reuptake inhibitors (SSRIs). The main objective of this pilot study was to compare cognitive behavioral therapy (CBT) versus SSRIs for the treatment of major depressive disorder (MDD) in patients with temporal lobe epilepsy (TLE). Seven patients who received group CBT were compared with eight patients treated with SSRIs. All were diagnosed with MDD and TLE. Patients were assessed at baseline before treatment and at six and 12 weeks during treatment with the Quality of Life in Epilepsy Scale of 31 items (QOLIE 31), the Beck Depression Inventory (BDI), and the Hospital Anxiety and Depression Scale (HADS). Seizure records were also taken on a monthly basis. After 12 weeks of treatment, both groups showed improved QOL and reduced severity of depression symptoms. There were no statistically significant group differences in the final scores for the BDI (p = 0.40) and QOLIE 31 (p = 0.72), although the effect size on QOL was higher for the group receiving CBT. In conclusion, the present study suggests that both CBT and SSRIs may improve MDD and QOL in patients with TLE. We found no significant outcome differences between both treatment modalities. These findings support further study using a double-blind controlled design to demonstrate the efficacy of CBT and SSRIs in the treatment of MDD and QOL in patients with TLE. |
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