Lifestyle factors, psychiatric and neurologic comorbidities, and drug use associated with incident seizures among adult patients with depression: a population-based nested case-control study

Abstract

To investigate risk factors for incident seizures among adult patients with depression. We conducted a nested case-control analysis in adult patients with newly diagnosed depression, using data from the U.K.-based Clinical Practice Research Datalink. Among cases with incident seizures and matched controls, we estimated odds ratios (ORs) with 95 % confidence intervals (CIs) of potential risk factors for seizures as reported from data of the general population: underweight (body mass index <18.5 kg/m²), smoking, alcoholism, drug abuse, psychiatric or neurologic comorbidities, and concomitant use of drugs. Of 186,540 patients with depression, 1489 developed a seizure during follow-up. Being underweight (OR 1.67 [95 % CI 1.23-2.26]), a current smoker (OR 1.45 [95 % CI 1.26-1.67]), having alcoholism (OR 2.98 [95 % CI 2.56-3.47]), and drug abuse (OR 2.51 [95 % CI 1.94-3.24]), were associated with increased risks of seizures compared to normal weight, non-smoking, no alcoholism, and no drug abuse, respectively. Previous stroke/transient ischemic attack (OR 6.07 [95 % CI 4.71-7.83]) or intracerebral bleeding (OR 8.19 [95 % CI 4.80-13.96]), and comorbid dementia (OR 6.83 [95 % CI 4.81-9.69]), were strongly associated with seizures. Current use of cephalosporins (OR 2.47 [95 % CI 1.61-3.78]) and antiarrhythmics (OR 1.59 [95 % CI 1.26-2.01]) was associated with an increased risk of seizures compared to non-use. Among adult patients with depression, being underweight, smoking, alcoholism, and drug abuse, were associated with seizures. Remote stroke and comorbid dementia were strong risk factors for seizures. Current use of cephalosporins or antiarrhytmics was associated with an increased risk of seizures compared to non-use.

Keywords: Depression; Depressive disorder; Risk factors; Seizures.