From the Research
The best management for psychogenic seizures involves a combination of psychotherapy and appropriate medication management, with psychotherapy being the primary treatment, as evidenced by the most recent study in 2022 1.
Key Components of Management
- Psychotherapy: Cognitive Behavioral Therapy (CBT) is the most effective therapy approach, typically delivered in 12-16 weekly sessions focusing on identifying triggers, managing stress, and developing coping strategies.
- Medication management: Avoid unnecessary antiepileptic drugs, and consider psychiatric medications for comorbid conditions, such as SSRIs (e.g., sertraline 50-200mg daily or fluoxetine 20-80mg daily) for depression or anxiety, or low-dose benzodiazepines (e.g., clonazepam 0.5-2mg) for acute anxiety, with cautious use due to dependence risk.
Multidisciplinary Approach
- Involving neurologists, psychiatrists, and psychologists to provide comprehensive care.
- Clear communication about the diagnosis, emphasizing the psychological origin of the seizures, is essential for patient acceptance and participation in therapy.
Treatment Outcomes
- Many patients experience significant reduction in seizure frequency with appropriate treatment, as shown in a study published in 2021 2, where 50% of patients improved by 50% or more in seizure frequency after attending at least 7 sessions of CBT-informed psychotherapy in longer than 3 months.
- Quality of life can be improved with treatment, although some patients may remain symptomatic and experience continued impairments, highlighting the need for long-term follow-up and ongoing support.