Of note is that some antiepileptic drugs, such as levetiracitam (Keppra®),46 can induce mood changes and therefore should be used with care in patients with epilepsy and depression. The rate of manic syndromes appear to be higher in epilepsy,47 and these usually are atypical in presentation and more likely to present with irritability and overactivity than idiopathic bipolar disorder, which itself does not appear to be more

prevalent in epilepsy relative to the general population. This has led to Inhibitors,research,lifescience,medical the belief that epilepsy-associated brain damage is a major component in the occurrence of mania and temporal lobe epilepsy. The prevalence of psychotic symptoms in interictal periods is on the order of 5% to 7% in patients with epilepsy In patients with temporal lobe Inhibitors,research,lifescience,medical epilepsy, these disturbances are often schizophrenia-like in their presentation. Paranoid or persecutory delusions and both visual and auditory hallucinations have been reported. Also “negative symptoms” of schizophrenia such as amotivation, apathy, flattened affect, and disorganized behavior have been reported in association with

delusions and hallucinations. This has given rise to the hypothesis of the “schizophrenialike psychoses of epilepsy” which remains controversial.48 Inhibitors,research,lifescience,medical Pulling it all together Several common themes emerge from this brief review of individual neurologic diseases and their psychiatric manifestations. First, regardless of the cause of the neurologic disease, these psychiatric disturbances have common features across diseases and fall into several definable and recognizable groups including

cognitive disorders (dementia and nondementia in severity), affective disorders (including major depression, atypical depressions, Inhibitors,research,lifescience,medical mania, and other bipolar disorders), anxiety disorders (in OTX015 mw particular generalized anxiety and panic disorders), and a range of phenomena indicative of executive dysfunction Inhibitors,research,lifescience,medical including apathy, disinhibitive or compulsive behaviors, personality change, and aggression-agitation. However, even though there are recognizable groupings that occur, across disorders there is considerable variability, which remains poorly characterized. For example, in some conditions, including stroke and TBI, classical conditions such as major depression can be seen, whereas in other conditions such as AD and to a lesser extent PD, classical Adenosine triphosphate major depression is less common than atypical mood disorders, In epilepsy, a mixture of typical and atypical disorders is seen. Another source of variability relates to the comorbidity of different psychiatric syndromes with each other. Most of the literature to date consists of efforts to describe individual psychiatric syndromes whose phenomenology comes from the Diagnostic and Statistical Manual of Mental Disorders. 4th ed (DSM-TV),49 or other a priori criteria sets, which are then investigated in individual brain diseases, though without much concern as to comorbidity.