Complicaciones Psiquiátricas de Antiepilépticos

Background: Epilepsy can occur at any age. Some people experience their first seizure in childhood, while others experience it in later life. Medications can help prevent seizures and maintain a good quality of life. Unfortunately, they are not always effective: approximately 3 in 10 people still experience seizures regularly. Several studies have shown that some antiepileptic drugs can induce or exacerbate symptoms such as depression, anxiety, irritability, personality changes, affective disorders, and even suicidal behavior. Methodology: A systematic review was conducted, searching the databases PubMed, Scielo, and ScienceDirect, among others. The following inclusion criteria were considered: Patients diagnosed with epilepsy receiving treatment with antiepileptic drugs, documented psychiatric complications, such as depression, anxiety, psychosis, irritability, suicidal ideation, among others, and articles in English or Spanish. Results: The use of antiepileptic drugs (AEDs) has radically transformed the management of epilepsy, allowing effective seizure control in most patients. However, as has been demonstrated, this therapeutic efficacy is not without consequences, especially in the field of mental health. The presence of psychiatric complications, ranging from mild affective symptoms to severe psychosis or suicidal behavior, represents a major clinical challenge, not only because of their impact on quality of life, but also because they are often underestimated or attributed exclusively to the underlying disease. Conclusions: The urgent need for systematic psychiatric monitoring during treatment with AEDs is emphasized, even in patients without a psychiatric history. This monitoring should include validated screening tools, periodic clinical interviews, and the active involvement of family members or caregivers in observing emotional or behavioral changes. The importance of a multidisciplinary approach in the treatment of epilepsy is highlighted. The interaction between neurologists, psychiatrists, clinical psychologists, social workers, and nursing staff allows for a more effective approach to the complexity of epilepsy patients, promoting a real, non-fragmented biopsychosocial approach.