teenage girl studying

Wagner et al., Epilepsy and Behavior, 97(2019), 22-28.

Children and adolescents with epilepsy are at higher risk for behavioral health problems such as

Antiepileptic drugs (AEDs) are commonly used in the treatment of pediatric epilepsy but carry the risk of side effects, including worsening of underlying behavioral symptoms. Socioeconomic status may also influence AED adherence and side effects. However, the complex relationship between behavioral health history, socioeconomic status, and AED side effects is not well understood. A more in depth understanding of these issues may help improve health-related quality of life for people and families and inform better clinical care.


The purpose of this study was to examine the relationship between AED side effects and behavioral symptoms as reported by individuals and their caregivers. The authors hypothesized that people with clinical symptoms of depression and anxiety would be more likely to report severe side effects than people without.

Description of Study

  • 231 children aged 8-18 years with a diagnosis of epilepsy were recruited from three epilepsy centers.
  • All children in the study had a diagnosis of epilepsy; people with chronic health conditions other than neurobehavioral comorbidities were excluded.
  • Individuals and their caregivers completed the Behavioral Assessment System for Children-2 (BASC-2) to assess for anxiety and depressive symptoms.
  • People were divided into two groups: those with high anxiety and depressive scores compared to those with average/low scores.
  • Caregivers completed the Pediatric Epilepsy Side Effects Questionnaire (PESQ) to assess for AED side effects and a background questionnaire to assess for other health conditions.

Summary of Study Findings

  • 16% of people self-reported high scores on the BASC-2 for depressive symptoms; 20% self-reported high scores for anxiety symptoms.
  • Caregiver reports of side effects were higher for people with depressive symptoms.
  • A higher percentage of kids with self-reported depressive symptoms experienced general neurological side effects.
  • Similarly, a higher percentage of kids with self-reported anxiety symptoms endorsed cognitive side effects.
  • AED side effects were also more likely to occur in people that were younger, had epilepsy longer, were of lower socioeconomic status, were on more than one medication, and had divorced parents.

What does this mean?

This study highlights how common behavioral health problems are among children with epilepsy and the need to screen for behavioral symptoms in addition to side effects. Information from these assessments can help inform treatment decisions and lead to fewer side effects in these people. Addressing these individual and caregiver concerns may improve quality of life and medication adherence.

Article published in Epilepsy & Behavior, August 2019.

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Authored By: 
Daniel Friedman MD
Authored Date: 
Reviewed By: 
Elaine Kiriakopoulos MD, MSc
Elaine Wirrell MD
Tuesday, October 22, 2019