Abstract Details

Title Impact of a Free Anti-seizure Medication Intervention on Anxiety and Depression in People Living with Epilepsy in the Republic of Guinea

Topic Global Health and Neuroepidemiology

Presentation(s) S1 - Global Health (1:00 PM-1:12 PM)

Poster/Presentation
Number 001

Objective To quantify anxiety and depression in people living with epilepsy (PLWE) in Guinea before and after anti-seizure medication (ASM) intervention.

Background Little is known about mental health in PLWE in Sub-Saharan Africa and how seizure freedom could improve outcomes.

Design/Methods PLWE were prospectively recruited in Conakry (March 2022) to receive free clinical consultations with neurologists to implement/augment treatment regimens with free ASMs. Inclusion criteria were: >12 years old and >=2 unprovoked seizures. As part of a broader interview, participants reported seizure frequency and completed scales screening for depression (PHQ-9) and anxiety (GAD-7). 90-day follow-up assessed adherence to ASMs and re-assessed seizure frequency and mental health scales.

Results

Of 148 participants enrolled (mean age=27.3 years, range 12–72; 45% female), 53.3% regularly took ASMs. Average seizure frequency over the 30 days pre-enrollment was 3.2 (SD=5.9; 28% seizure-free during this period).

Treatment regimens were modified for 95% of participants, mostly consisting of new levetiracetam provision (n=115). At 90 days, retention was 78.4% (n=116). Average adherence was 87.0%. Average seizure frequency over the prior 30 days was 1.5 (SD=5.7; 66% seizure-free during this period).

At baseline, average PHQ-9 score was 21.2 (95%CI [20.2,22.2]), indicating severe depressive symptoms, and average GAD-7 score was 16.5 [15.6,17.4], indicating severe anxious symptoms. At 90-days, average PHQ-9 was 17.5 [16.4,18.5] and significantly lower than baseline (p<.001). Average GAD-7 was 14.4 [13.6,15.3] and significantly lower than baseline (p=.002). Seizure frequency was not correlated with PHQ-9 (p=.50) nor GAD-7 (p=.10) scores at baseline but was at 90-days (PHQ-9: r=.24, p=.01; GAD-7: r=.22, p=.02).

Conclusions High levels of anxiety and depression occur in PLWE in Guinea, underscoring the unmet psychiatric needs in un- and under-treated epilepsy and the need for collaboration between neurologists and psychiatrists. Medication intervention may positively impact mental health, highlighting seizure control in addition to psychiatric intervention for this population.

Authors/Disclosures
Dylan R. Rice PRESENTER	Mr. Rice has nothing to disclose.
Guelngar Carlos Othon, Jr., MD (National Ignace Deen Hospital, University of Conakry)	Guelngar Carlos Othon has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Nathanael J. Lee, MD, PhD (Nathanael Lee)	Dr. Lee has nothing to disclose.
	No disclosure on file
Farrah J. Mateen, MD, PhD, FAAN (Massachusetts General Hospital)	Dr. Mateen has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics (Amgen). Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology. The institution of Dr. Mateen has received research support from Genentech. The institution of Dr. Mateen has received research support from EMD Serono. The institution of Dr. Mateen has received research support from Novartis. The institution of Dr. Mateen has received research support from Horizon Therapeutics (Amgen). The institution of Dr. Mateen has received research support from TG Therapeutics. Dr. Mateen has received intellectual property interests from a discovery or technology relating to health care.

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