Research & Publications
Impact of Depression on Treatment Patterns and Outcomes in Patients With Newly Diagnosed Epilepsy
American Epilepsy Society
December 2025
Summary
This retrospective cohort study analyzed 100% Medicare Fee-for-Service claims and Inovalon’s MORE² Registry® of closed claims to evaluate treatment patterns and outcomes among patients newly diagnosed with epilepsy, stratified by the presence of comorbid depression. The analysis included 90,738 patients initiating a first line of antiseizure medication between 2017 and 2019 and followed treatment progression across up to four lines of therapy. The study assessed treatment duration, line-of-therapy changes, and risk of treatment failure in patients with and without depression.
Key Findings
- Depression was common: About one in four patients with newly diagnosed epilepsy also had depression.
- Shorter time on first treatment: Patients with depression stayed on their first antiseizure medication for a shorter time than those without depression (145 vs. 173 days).
- Higher chance of treatment failure: Even after adjusting for patient characteristics, those with depression were about 40% more likely to stop, switch, or add to their first treatment.
- More complex health needs: Patients with depression had higher rates of other mental health conditions and chronic medical illnesses, indicating a higher overall burden of disease.
Why This Matters
These real-world findings demonstrate that comorbid depression is associated with earlier treatment disruption and greater clinical complexity among patients with newly diagnosed epilepsy. Shorter persistence on initial therapy and higher treatment failure rates may reflect challenges related to tolerability, effectiveness, or care coordination. The results highlight the importance of integrating mental health considerations into epilepsy treatment planning to support sustained therapy, improve outcomes, and better address the needs of this high-risk subgroup.
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