Retrospective analysis of aripiprazole augmentation and serotonin norepinephrine reuptake inhibitor switching in epilepsy patients with selective serotonin reuptake inhibitors-resistant depression

Abstract

Depression is a significant comorbidity of epilepsy that affects both quality of life and seizure control. Selective serotonin reuptake inhibitors (SSRIs) are the recommended first-line treatment for depression in patients with epilepsy; however, the optimal management strategies for SSRI-resistant depression in this population remain unclear. We conducted a 10-year retrospective analysis of epilepsy patients with SSRI-resistant depression who were treated by either switching to a serotonin norepinephrine reuptake inhibitor (SNRI) or augmenting with aripiprazole. We compared demographic factors, seizure characteristics, and treatment outcomes between the two groups. Our study included 33 epilepsy patients with SSRI-resistant depression who switched to SNRIs and 36 patients who were treated with aripiprazole augmentation. There were no significant differences in demographic factors, seizure characteristics, mean initial depression scores, or seizure freedom between the groups. However, patients receiving aripiprazole augmentation showed higher retention rates than those switching to SNRIs at their last follow-up (28/36 vs. 13/33, p =.001). Our study suggests that aripiprazole augmentation may be a more favorable option than switching to SNRIs for epilepsy patients with SSRI-resistant depression. Further prospective studies are needed to investigate effective treatment strategies for epilepsy patients with SSRI-resistant depression.