Anxiety and Epilepsy

An anxiety disorder is characterized by constant feelings of worry, nervousness or intermittent panic attacks. People with anxiety disorders may feel "on edge". There are different types of anxiety disorders including:

  • Generalized Anxiety Disorder
  • Panic Disorder
  • Post Traumatic Stress Disorder
  • Obsessive Compulsive Disorder

Anxiety disorders are common in the general population and are more common among people with epilepsy. We all experience feelings of anxiety and nervousness. Anxiety becomes a disorder when the feelings are frequent or intense, are produced by trivial things or nothing at all, and interfere with our functioning.

What causes anxiety ?

As with depression, several factors can be part of the cause of anxiety disorders including psychological stress related to the epilepsy, medication effects, associated neurological or psychiatric disorders, and the epilepsy itself.

How is an anxiety disorder treated ?

Anxiety disorders can be effectively treated with counseling, therapy, and medications. A newer medication to treat anxiety, buspirone (Buspar), is safe for almost all patients with epilepsy and anxiety. The SSRIs, listed in the section on depression, also can be helpful in treating anxiety. The benzodiazepines are very effective in the short-term treatment of anxiety and insomnia, but they should be avoided if possible because they are among the most habit-forming (addictive) drugs legally available. They include:

  • clobazam (Frisium; not available in the US)
  • clonazepam (Klonopin)
  • diazepam (Valium)
  • alprazolam (Xanax)
  • chlordiazepoxide (Librium)
  • clorazepate (Tranxene)
  • estazolam (Prosom)
  • lorazepam (Ativan)
  • triazolam (Halcion)

These drugs also may temporarily reduce seizure frequency and intensity but after someone takes the same dose for a period of weeks, the effect on anxiety, insomnia, and seizure control diminishes. As the original anxiety or seizures return, there is a strong tendency for the patient and doctor to increase the dose, which again briefly reduces troublesome symptoms. This cycle leads to a buildup of the dose to levels that can cause memory impairment, depression, tiredness, and other problems. If the dose is then reduced, the real trouble begins: anxiety, insomnia, and seizures become more severe.

When anxiety is severe, other more powerful drugs such as the antipsychotic drugs may be used.