54 YOF suffers from generalized seizures; currently on Effexor, valproate and Topomax for seizure and clinical depression. Experiencing social anxiety in which can no longer talk on phone or go out in public without progressive anxiety. would clonazepam be more efficacious in treatment of seizure+anxiety disorder over valproic acid?
Dear Tiffany,
perhaps these papers give you an idea:
Article Pharmacoresistant partial-onset epilepsy misdiagnosed as pan...
Article Anticonvulsant prescription patterns in patients covered by ...
Article Treatment of depression in patients with temporal lobe epile...
Article A comparison of the nature and correlates of panic attacks i...
Article The pharmacological management of psychiatric comorbidities ...
Cognitive behavioral therapy is probably the most effective treatment of anxiety.
Hi Tiffani. It is absolutely correct, as Dr. Ewalds-Kvist noted, that partial-complex seizures may present with panic attacks. A more common comorbidity is bipolar disorder. In my experience, those patients also respond robustly and quickly to valproate therapy. I could not find a copy to enclose, but see
Henry C, Van den Bulke D, Bellivier F, Etain B, Rouillon F, LeBoyer M. Anxiety disorders in 318 bipolar patients. Journal of Clinical Psychiatry 2003;64(3): 331-335
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