Optimizing therapy of seizures in adult patients with psychiatric comorbidity.

This article provides an overview of appropriate antiepileptic treatment in adult patients with chronic epilepsy and concomitant psychiatric disorders. It highlights the influence of various treatment options for epilepsy on psychiatric symptoms. Six specific topics are discussed: psychosocial aspects and treatment compliance; positive and negative psychotropic effects of antiepileptic drugs (AEDs); pharmacokinetic and pharmacodynamic interactions between AEDs and psychoactive drugs; risks and benefits of resective surgery; the effect of vagal nerve stimulation; and recommended strategies for optimizing epilepsy therapy in patients with psychiatric disorders. Given the multitude of epilepsy treatment options with various CNS effects, it is crucial to select treatments according to the clinical profile of each individual patient.