Describe the prevalence of psychiatric comorbidities and use of psychotropic medications in patients with Lennox-Gastaut Syndrome (LGS).

LGS is a pharmacoresistant childhood-onset epileptic encephalopathy  that is accompanied by behavioral comorbidities, hyperactivity, and psychosis. Up to 90% of patients develop neuropsychiatric disorders, which tend to worsen over time, even if seizures improve.

An observational, descriptive, cross-sectional study was conducted on patients diagnosed with LGS at our Epilepsy Clinic, SPSS® 23 was used for data analysis. Quantitative variables were summarized with mean and standard deviation, while qualitative variables were expressed as frequencies and percentages.

Forty patients were included, 27  (67.5%) men, with a mean age of 35.8 ± 9.3 years. The average number of antiseizure drugs (ASD) was 3.4 ± 3. Among all, 28 patients (70%) underwent surgery, primarily anterior callosotomy (21, 52.5%). Generalized seizures were common in 29 patients (72.5%), and epilepsy was mostly combined (30, 75%). All 40 patients (100%) had intellectual developmental impairments. Additionally, 21 patients (52.5%) presented psychiatric comorbidities. Among them, 10 (25%) experienced aggression and behavioral disturbances, 4 (10%) had psychosis, 3 (7.5%) had depression, 1 (2.5%) reported anxiety, and 1 (2.5%) faced sleep disturbances. Psychotropic medications were administered to 24 patients (60%), with 5 (12.5%) receiving risperidone as monotherapy, followed by sertraline in 3 (7.5%), fluoxetine in 2 (5%), and clonazepam, haloperidol, and quetiapine in 1 (2.5%) each. Additionally, polytherapy was utilized, including risperidone with SSRIs in 3 (7.5%) and fluoxetine with olanzapine in 2 (5%).

The most common comorbidity was intellectual developmental impairments. Moreover, half of the patients had psychiatric comorbidities, with behavioral disturbances and psychosis being the most common, as documented in literature. This highlights the importance of early diagnosis and treatment, as these conditions worsen prognosis.