Case report identifies effective screening and first-line antidepressant therapy for anticipatory seizure anxiety in epilepsy, highlighting the need for routine psychiatric assessment.
• Anticipatory Anxiety of Seizures(AAS) is frequent and impairs quality of life in PWE. • Existing screening scales for anxiety in PWE are GAD-7 and EASI. • Neurologists could ask about the presence of an excessive worry of having a seizure. • Sertraline or Citalopram can be used as the first-line pharmacological treatment. Anxiety disorders affect roughly 25% of people with epilepsy (PWE), and are associated with a strong impairment of quality of life and a poorer stabilization of epilepsy. Anticipatory anxiety of seizure (AAS), defined by the persistent worry or fear to have another seizure, is highly frequent and associated with avoidant behavior. Unfortunately, AAS is often overlooked and untreated. Here, we present the case of a 35-year-old patient suffering from AAS secondary to focal epilepsy. We aimed to provide practical guidelines and tools for the screening and treatment of anxiety disorders in PWE. Regarding psychotropic medication, Sertraline or Citalopram might be good options for first-line treatment of AAS, since they are efficient against anxiety and well-tolerated in epilepsy.
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Hingray et al. (2024) studied this question.
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