| Epilepsy is a common disease, and its morbidity is increasing with aging and increase of the working pressure.Unpredictability of epileptic attack, concern about long-term side effects occur, and the people's misunderstanding have caused psychological problems of epileptic patients.And depression is the most common one. Unfortunately, in the long-term treatment of epilepsy, doctors only pay great attention to the control of epileptic sezure,but neglect the treatment of psychological problems, so the quality of patients lives were not improved in despite of the good control of seizure. In order to enhance the quality of life of epileptic patiens with depression, the study research on antidepressant therapy efficacy and safety, and the new pattern of treatment of these patiens.Collected 60 cases of epileptic patients with depression, and divided into treatment group (40 cases) and observation group (20 cases) randomly.All patients were assessed with 24 Hamilton (HAMD) depression scale scores, monitoring the quality of life questionnaire-31 (QOLIE-31) score, shame scale (SS) score, there was no statistical difference between scores of the two groups. Patients of observation group were only treated with antiepileptic drugs(carbamazepine or sodium valproate), whereas patients of treatment group were treated with antiepileptic drugs(carbamazepine or sodium valproate) and antidepressant (Sertraline,50mg/d, po).2.Assessment of effectiveness①3 months later, all patients were assessed with the scales.And statistics were adopted to the scores before and after treatment of treatment group and control group respectively;②Assessment of effectiveness:clinical control:no seizure after treatment;improvement:frequency of seizure reduces over 75%; effectiveness:frequency of seizure reduces 50%-75%,seizure time shortens, and symptoms significantly decrease;ineffectiveness:attack frequency reduces less than 50%, and no decrease of the symptoms.3.drug safety evaluation:original antiepileptic drugs of treatment group were not changed. When antidepressant drugs were added, the frequency of seizures (times/month) (exclusion of mental stimulation and emotional changes and other non-drug-induced factors),and changes of the functionality of the system and the spirit were assessed to evaluate the safety of antidepressant drugs. Increased attack frequency showed that the antidepressant drugs can trigger or aggravate epilepsy; no apparent change in frequency shows that the antidepressant drugs have no affection on epilepsy; decrease frequency shows that the antidepressant drugs have a synergistic effect with antiepileptic drugs.At the same time, observe the affection of antidepressant drugs on the blood and lymphatic system, cardiac, endocrine, gastrointestinal tract, liver and gallbladder system, immune system, the nervous system, the spirit, and kidney of epileptic patients.1.There was significant difference between the scale scores before and after treatment of the treatment group (p<0.05)。Depression, shame, and inferiority of the patients were alleviated. They had better social function, and the quality of life had improved significantly.2.There was no significant difference between the scale scores before and after treatment of the observation group (p>0.05).Despite that seizures were well controlled with aggressive treatment, no differences were found in depression, shame, and inferiority of the patients.similarly, social function and the quality of life were not improved.3. There were no significant differences between the attack frequency and the side effects of the observation group and treatment group.Sertraline in 50mg/d dose does not increase epilepsy attacks, other system side-effects and observation group rate difference no statistically |
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