Alcohol Use Disorder and Depression in Patients with Alcohol-Related Seizures

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Both alcohol use disorder and depression are important aspects of health in the general population and among patients with epilepsy. Depression is the most prevalent psychiatric comorbidity in epilepsy, thereby increasing morbidity as well as mortality rate. From our experience, we can see that one third of epilepsy inpatients experience seizures that are alcohol-related. There have been no studies conducted in Latvia about alcohol use disorder and depression in patients with alcohol-related seizures (ARS) and epilepsy. We recruited 108 patients with ARS, 44 of whom had comorbid epilepsy. 75% of patients in our study had depression according to the Hamilton depression scale. Higher score in the Alcohol Use Disorder Identification Test was associated with thoughts of self-harm. Greater consumption of alcohol on a typical day when drinking was associated with a higher risk of alcohol dependence. Of patients without epilepsy, 60% received antiepileptic drugs (AEDs) and 17% even used 2–3 different drugs to overcome ARS. A large part of patients had not been warned by their physician that alcohol provokes seizures. Our data could help to identify greater suicidality risk and alcohol dependence risk cases in patients with ARS, as well as improve care for this group of patients in general.

Anonymous (1993). World Health Organization. The ICD10 Classification of Mental and Behavioural Disorders: Diagnostic criteria for research, World Health Organization, Geneva. Available at: (acessed 21 July 2017).

Anonymous (2015). Ieteikumi ģimenes ārstiem alkohola atkarības profilaksē [Recommendations for Family Doctors on Prophylaxis of Alcohol Dependance]. The Centre for Disease Prevention and Control of Latvia. Available at: (accessed 20 July 2017) (in Latvian).

Babor, T., Campbell, R., Room, R., Saunders, J. (eds.) (1994). Lexicon of Alcohol and Drug Terms. World Health Organization, Geneva. 69 pp.

Babor, T., Higgins-Biddle, J., Saunders, J., Monteiro, M. (2001). AUDIT. The Alcohol Use Disorders Identification Test. Guidelines for use in primary care. Second edition. World Health Organization. Available at: (accessed 20 July 2017).

Boden, J., Fergusson, D. (2011). Alcohol and depression. Addiction, 106 (5), 906–914.

Boschloo, L., Vogelzangs, N., Smit, J., van den Brink, W., Veltman, D., Beekman, A., Penninx, B. W. (2011). Comorbidity and risk indicators for alcohol use disorders among persons with anxiety and/or depressive disorders: Findings from the Netherlands Study of Depression and Anxiety (NESDA). J. Affect. Disord., 131 (1–3), 233–242.

Brathen, G., Brodtkorb, E., Helde, G., Sand, T., Bovim, G. (1999). The diversity of seizures related to alcohol use. A study of consecutive patients. Eur. J. Neurol., 6, 697–703.

Cramer, J., Blum, D., Reed, M., Fanning, K.; Epilepsy Impact Project Group. (2003). The influence of comorbid depression on quality of life for people with epilepsy. Epilepsy Behav., 4 (5), 515–521.

de Oliveira, G., Kummer, A., Salgado, J., Filho, G., David, A., Teixeira, A. (2011). Suicidality in temporal lobe epilepsy: Measuring the weight of impulsivity and depression. Epilepsy Behav., 22 (4), 745–749.

Devinsky, O., Spruill, T., Thurman, D., Friedman, D. (2016). Recognizing and preventing epilepsy-related mortality: A call for action. Neurology, 86 (8), 779–786.

Fiest, K., Dykeman, J., Patten, S., Wiebe, S., Kaplan, G., Maxwell, C., Bulloch, A., Jette, N. (2013). Depression in epilepsy: A systematic review and meta-analysis. Neurology, 80 (6), 590–599.

Freedland, E., McMicken, D. (1993). Alcohol-related seizures, Part II: Clinical presentation and management. J. Emerg. Med., 11 (5), 605–618.

Gandy, M., Sharpe, L., Perry, K. N., Miller, L., Thayer, Z., Boserio, J., Mohamed, A. (2013). Rates of DSM-IV mood, anxiety disorders, and suicidality in Australian adult epilepsy outpatients: A comparison of well-controlled versus refractory epilepsy. Epilepsy Behav., 26 (1), 29–35.

Gordon, E., Devinsky, O. (2001). Alcohol and marijuana: Effects on epilepsy and use by patients with epilepsy. Epilepsia, 42 (10), 1266–1272.

Graham, K., Massak, A., Demers, A., Rehm, J. (2007). Does the association between alcohol consumption and depression depend on how they are measured? Alcohol Clin. Exp. Res., 31 (1), 78–88.

Hamilton, M. (1960). A rating scale for depression. J. Neurol. Neurosurg. Psychiatry, 23, 56–62.

Hasin, D., Tsai, W., Endicott, J., Mueller, T., Coryell, W., Keller, M. (1996). Five-year course of major depression: Effects of comorbid alcoholism. J. Affect. Disord., 41 (1), 63–70.

Hecimovic, H., Santos, J. M., Carter, J., Attarian, H. P., Fessler, A. J., Vahle, V., Gilliam, F. (2012). Depression but not seizure factors or quality of life predicts suicidality in epilepsy. Epilepsy Behav., 24 (4), 426–429.

Hesdorffer, D., Hauser, W., Olafsson, E., Ludvigsson, P., Kjartansson, O. (2006). Depression and suicide attempt as risk factors for incident unprovoked seizures. Ann. Neurol., 59 (1), 35–41.

Hoppe, C., Elger, C. (2011). Depression in epilepsy: A critical review from a clinical perspective. Nat. Rev. Neurol., 7 (8), 462–472.

Hoppener, R., Juyer, A., van der Lugt, P. (1983). Epilepsy and alcohol: The influence of social alcohol intake on seizures and treatment in epilepsy. Epilepsia, 24, 459–452.

Jackson, M., Turkington. D. (2005). Depression and anxiety in epilepsy. J. Neurol. Neurosurg. Psychiatry, 76 Suppl 1, i45–i47.

Lewis, A. J. (1934). Melancholia: A historical review. J. Ment.Sci., 80, 1–42.

Kanner, A. M. (2016). Management of psychiatric and neurological comorbidities in epilepsy. Nat. Rev. Neurol., 12 (2), 106–116.

Lehrner, J., Kalchmayr, R., Serles, W., Olbrich, A., Pataraia, E., Aull, S., Bacher, J., Leutmezer, F., Gröppel, G., Deecke, L., Baumgartner, C. (1999). Health-related quality of life (HRQOL), activity of daily living (ADL) and depressive mood disorder in temporal lobe epilepsy patients. Seizure, 8 (2), 88–92.

Mattson, R., Fay, M., Sturman, J. (1990). The effect of various patterns of alcohol use on seizures in patients with epilepsy. In: Porter, R., Mattson, R., Cramer, J. (eds.). Alcohol and Seizures:Basic Mechanisms and Clinical Concepts. FA Davis, Philadelphia, pp. 233–240.

Mula, M. (2017). Depression in epilepsy. Curr. Opin. Neurol., 30 (2),180–186.

Pirkola, S., Isometsä, E., Suvisaari, J., Aro, H., Joukamaa, M., Poikolainen, K., Koskinen, S., Aromaa, A., Lönnqvist, J. (2005). DSM-IV mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population-results fromthe Health 2000 Study. Soc. Psychiatry Psychiatr. Epidemiol., 40 (1), 1–10.

Rai, D., Kerr, M., McManus, S., Jordanova, V., Lewis, G., Brugha, T. (2012). Epilepsy and psychiatric comorbidity: A nationally representative population-based study. Epilepsia, 53 (6), 1095–1103.

Rathlev, N., Ulrich, A., Delanty, N., D’Onofrio, G. (2006). Alcohol-related seizures. J. Emerg. Med., 31 (2), 157–163.

Suna, N., Lazdane, M., Gulbe, G., Karelis, G., Vitols, E. (2015). Epilepsy and alcohol provoked seizures: Patient analysis in general neurology department. In: Abstracts of the 8th Baltic Congress of Neurology, Balcone 2015. Proc. Latv. Acad. Sci., Sect. B., 69 (5), A21.

Tellez-Zenteno, J. F., Patten, S. B., Jetté, N., Williams, J., Wiebe, S. (2007). Psychiatric comorbidity in epilepsy: A population-based analysis. Epilepsia, 48 (12), 2336–2344.

Thompson, W. (1978). Management of alcohol withdrawal syndromes. Arch. Intern. Med., 138 (2), 278–283.

Wiegartz, P., Seidenberg, M., Woodard, A., Gidal, B., Hermann, B. (1999). Co-morbid psychiatric disorder in chronic epilepsy: recognition and etiology of depression. Neurology, 53 (5 Suppl 2), S3–S8.

Journal Information

CiteScore 2017: 0.22

SCImago Journal Rank (SJR) 2017: 0.127
Source Normalized Impact per Paper (SNIP) 2017: 0.211


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