Suicidality at Epilepsy Diagnosis and Future Treatment Resistance in Adults With Focal Epilepsy

In individuals with new-onset focal epilepsy, does the presence of current or past suicidality and mood and/or anxiety disorder at epilepsy diagnosis increase the risk of developing future treatment resistance to antiseizure medications (ASMs)?In this cohort study of 376 adult participants, suicidality (past or current) at time of focal epilepsy diagnosis was associated with a 2-fold increased risk of developing drug resistance, whereas depression and/or anxiety disorder were not. The presence of suicidality without comorbid mood or anxiety increased the probability of developing treatment resistance more than those with suicidality and depression.Results suggest that psychiatric screening for the presence of suicidality at time of epilepsy diagnosis, even in the absence of other psychiatric comorbidities, may facilitate early identification of patients at risk for treatment-refractory epilepsy syndromes.

Corresponding Author: Sarah N. Barnard, MD, MIPH, Department of Neuroscience, School of Translational Medicine, Monash University, 99 Commercial Rd, Melbourne 3001, Australia (sarah.barnard@monash.edu).

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