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1 results

  • Epilepsy and psychosis: navigating through a complex intersection

  • Marco Mula, Andres M. Kanner, Allan H. Young, Annabella Di Giorgio, Andreas Schulze-Bonhage, Eugen Trinka
  • Journal:
    BJPsych Open / Volume 11 / Issue 4 / July 2025
    Published online by Cambridge University Press:
    26 June 2025, e127
    • Article
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  • Background

    The prevalence of psychiatric disorders in people with epilepsy is as high as 43% and, among them, psychoses represent a severe comorbidity.

    Aims

    This is a narrative review discussing the interplay between epilepsy and psychosis and identifying challenges in diagnosing and managing psychotic symptoms in epilepsy, focusing on the past 10 years.

    Method

    Articles published between June 2014 and December 2024 were identified through searches in PubMed using the search terms ‘psychosis’, ’seizure, epilepsy and convulsion’, ‘epile*’, ’seizure*’ and ‘convuls*’.

    Results

    The association between epilepsy and psychosis was shown to be bidirectional, with people with psychosis being at increased risk of epilepsy. In epilepsy, psychotic symptoms may occur in three clinical scenarios, with clinical presentation and management varying in relationship to these: seizure-related (peri-ictal), treatment-related or independent of the former.

    Conclusions

    There are no guidelines for the management of psychotic symptoms in epilepsy, but it is possible to apply policies for the treatment of psychoses, taking into account the peculiarities and needs of people with epilepsy.