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Trial examines treatment for psychogenic nonepileptic seizures

Date:
July 2, 2014
Source:
The JAMA Network Journals
Summary:
A clinical trial found a reduction in seizures and improvement in related symptoms, including depression and anxiety, in patients with psychogenic nonepileptic seizures who were treated with cognitive behavioral therapy informed psychotherapy with and without the medication sertraline.
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A clinical trial found a reduction in seizures and improvement in related symptoms, including depression and anxiety, in patients with psychogenic nonepileptic seizures (PNES) who were treated with cognitive behavioral therapy informed psychotherapy (CBT-ip) with and without the medication sertraline.

PNES is not responsive to standard treatment and can be made worse by antiepileptic medications. Up to 20 percent of civilians and as many as 25 percent of veterans diagnosed as having epilepsy actually have PNES. PNES has psychological underpinnings but much less is known about effective treatments.

The authors assigned 38 patients (34 were included in the analysis) to 1 of 4 treatment groups: Medication (flexible dose sertraline hydrochloride) only, CBT-ip only, CBT-ip with medication (sertraline) or treatment as usual (generally tapering antiepileptic medication use and a referral to a psychiatrist or psychologist).

The psychotherapy (CBT-ip) group had a 51.4 percent reduction in seizure and improvement in other measures, including depression, anxiety, quality of life and global functioning. The CBT-ip with sertraline group had a 59.3 percent reduction in seizures and improvements in other measures including global functioning. The sertraline-only group showed no significant reduction in seizures and the treatment as usual group showed no significant reduction in seizures or improvement in other measures.

"This study supports the use of manualized psychotherapy for PNES and successful training of mental health clinicians in the treatment. Future studies could assess larger-scale intervention dissemination," researchers noted.


Story Source:

The above post is reprinted from materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. W. Curt LaFrance, Grayson L. Baird, John J. Barry, Andrew S. Blum, Anne Frank Webb, Gabor I. Keitner, Jason T. Machan, Ivan Miller, Jerzy P. Szaflarski. Multicenter Pilot Treatment Trial for Psychogenic Nonepileptic Seizures. JAMA Psychiatry, 2014; DOI: 10.1001/jamapsychiatry.2014.817

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The JAMA Network Journals. "Trial examines treatment for psychogenic nonepileptic seizures." ScienceDaily. ScienceDaily, 2 July 2014. <www.sciencedaily.com/releases/2014/07/140702170034.htm>.
The JAMA Network Journals. (2014, July 2). Trial examines treatment for psychogenic nonepileptic seizures. ScienceDaily. Retrieved September 2, 2015 from www.sciencedaily.com/releases/2014/07/140702170034.htm
The JAMA Network Journals. "Trial examines treatment for psychogenic nonepileptic seizures." ScienceDaily. www.sciencedaily.com/releases/2014/07/140702170034.htm (accessed September 2, 2015).

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