Epilepsy Talk

Schizophrenia and Epilepsy — The Connection | September 20, 2013

There’s always been a suspicion of the possible ties between epilepsy and schizophrenia.

But now, research has shown that schizophrenia and epilepsy are linked in both directions.

Previous studies had suggested a prevalence of schizophrenia and psychosis among epilepsy patients.

An early Danish study of more than 2 million people concluded, there’s a “strong association” between epilepsy and schizophrenia.

People with epilepsy had about 2.5 times the risk of schizophrenia as the general population, reported researchers.

Yet that’s “fairly low,” says Charles Raison, MD. Former consulting psychiatrist for the epilepsy service at the University of California at Los Angeles.

“Most people with epilepsy probably aren’t in danger of schizophrenia, he says.”

He said that the schizophrenia risk is very small — about 1%, in general.

But even with the higher risk cited in the study, people with epilepsy still have only a 2-3 in 100 chance of developing schizophrenia.

“That’s of some concern,” says Raison: but you can get a large increase in risk [and] if the risk is small, you’re still very safe.”

Yet there was the psychosis factor, too.

He questioned when to call chronic psychotic conditions schizophrenia.

The findings “probably reflect an underlying link, physiologically.

There may be abnormalities in the ways neurons are wired together.”

Those problems may develop early in life and manifest later on, usually in early adulthood.

In another previous study from Johns Hopkins, entitled “Schizophrenia and Epilepsy: Is There a Shared Susceptibility?” the authors suggested that “genes implicated in neuro-development may play a common role in both conditions.”

Now, in a breakthrough study, researchers in Taiwan say this could be due to genetic, neurobiological or environmental factors.

Research results showed a strong bidirectional relation between schizophrenia and epilepsy.

Dr Manny Bagary, consultant neuropsychiatrist in Birmingham, said “We have been aware that epilepsy sufferers seem to have an increased risk of psychosis but this is the first convincing study to suggest that people with schizophrenia could also be at risk of developing epilepsy, suggesting a bidirectional relationship has been found between depression and epilepsy”.

The link was confirmed when the Taiwan researchers found study participants with epilepsy were nearly 8 times more likely to develop schizophrenia, and those with schizophrenia were nearly 6 times more likely to develop epilepsy.

There was a slightly higher rate of schizophrenia in men with epilepsy than in women.

“Our research results show a strong bidirectional relation between schizophrenia and epilepsy,” said lead author I-Ching Chou, M.D., with China Medical University Hospital and Associate Professor with China Medical University in Taichung, Taiwan.

“This relationship may be due to common pathogenesis in these diseases such as genetic susceptibility and environmental factors, but further investigation of the pathological mechanisms are needed.”

Dr Manny Bagary, consultant neuropsychiatrist in Birmingham, said: “We have been aware that epilepsy sufferers seem to have an increased risk of psychosis but this is the first convincing study to suggest that people with schizophrenia could also be at risk of developing epilepsy, suggesting a bidirectional relationship has been found between depression and epilepsy”.

Future research will be focused on when to consider chronic psychotic conditions schizophrenia and their role in epilepsy.

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    Pingback by Schizophrenia and Epilepsy — The Connection | Epilepsy Talk | Hey Sweetheart, Get Me Rewrite! — September 15, 2013 @ 4:12 PM

  2. This is terrible news… A big step back for everyone with epilepsy! How long have we fought to be taken seriously by family, friends, and at work? Those who already believe the myths about epilepsy and/or are afraid of epilepsy, will now point to these studies to win arguments with friends or relatives with epilepsy. Potential employers will use the studies to justify their decisions to refuse to hire someone with epilepsy. Everyone seems to believe s/he is an amateur psychiatrist and will “diagnose” mental illness where it does not exist.


    Comment by Laura M — September 15, 2013 @ 7:43 PM

    • Sigh. Yes, one more arrow pointing to us as crazy. But, there are many other arrows. (Not that it’s a good thing!)

      Wait until the next article dealing with psychosis. More fuel for the fire.

      In the meantime, try to educate everyone you can. That’s what helps the most.


      Comment by Phylis Feiner Johnson — September 16, 2013 @ 10:49 AM

  3. Hmm, i guess with my Brain tumor and Epilepsy, that makes me a great candidate for being a schizo and a psycho, Doh!@#$

    How does one test for these things? I can put my hand on my nose when directed. I don’t hear strange things and i don’t have hallucinations unless if i’m on my Emergency Epilepsy pills.


    Comment by Zolt — September 16, 2013 @ 5:04 PM

  4. Sorry Zolt. No chocolate chip cookie for you!

    Unless you go through neuroimagining and neuropathological testing which tie the abnormalities of mesial temporal lobe structures with schizophrenia itself.

    Not very likely.

    If you have temporal lobe dysfunction, you may be one of the lucky 1% of people with epilepsy who have the same cognitive impairments as schizophrenia.

    Genetic testing could provide a clue.

    Multiple factors are involved in schizophrenia, such as genetic, environmental and social settings.

    Short-lived illnesses similar to paranoid schizophrenia are associated with cocaine, amfetamines and cannabis.

    Cannabis use especially, has been noted to be a culprit in both established schizophrenia and in enhancing future risk of schizophrenia in those who have not yet developed psychotic symptoms. 😦

    But basically, it comes down to temporal lobe epilepsy with neuroimaging and neuropathological testing.

    The other option is a biopsy of the brain. And no one is standing up to volunteer for that.

    Aren’t you glad you asked?


    Comment by Phylis Feiner Johnson — September 16, 2013 @ 7:17 PM

  5. Hmm, i really don’t think Cannabis use will do that, unless if you are already prone for Schizo and phsycotic problems. I know plenty of people in high places that have smoked for very long time. Plus there is really no real evidence on what cannabus does. There is that smoke stigma attached whenever a doctor hears someone smokes, they make all type of wild associations. So when i hear studies i’m really skeptical about their prejudices. Lets face it according to docs, they think all ailments are caused by smoking.

    Yet they don’t tell you that the oldest lady that ever lived smoked all her life.

    ” Mme Jeanne Calment, who was listed as the world’s oldest human whose birth date could be certified, died at 122. She had begun smoking as a young woman. At 117 she quit smoking (by that age she was just smoking two or three cigarettes per day because she was blind and was too proud to ask often for someone to light her cigarettes for her). But she resumed smoking when she was 118 because, as she said, not smoking made her miserable and she was too old to be made miserable. She also said to her doctor: “Once you’ve lived as long as me, only then can you tell me not to smoke.” Good point! [USA Today, “Way to go, champ,” 10/18/95].

    When Mme. Calment died at 122 in l997, the new longevity champ became 116-year-old Marie-Louise Meilleur, of Canada. Mme. Meilleur had chain-smoked all her adult life (as her grandson said, “She always had a cigarette dangling from her lips as she worked,”–AP, 8/15/97, reported in Miami Herald, p. 2A). She did give up smoking, however, when she was nearly 100. ”

    George burns once said, if he knew he would live till 100 yrs old, he would of quit smoking a long time ago. 🙂


    Comment by Zolt — September 18, 2013 @ 2:17 PM

  6. And Jackie Kennedy said: “If I knew I was going to die so young, I would have had more desserts!”

    As for smoking, my mother is a chain smoker and she’s 82. (And a healthy 82, at that.)

    Smoking is what it is. Smoking marijuana is a little different.

    I have a friend who smoked pounds of marijuna. Her reward was a severely disabled child.

    As for marijuana making you schizophrenic, I agree with you on all counts.

    I think it may exarberate an already present condition, but i don’t think, by itself, it will make you “crazy”.

    There have been studies and here are some links.

    Are the Benefits of Medical Marijuana Being Completely Overlooked?


    Cannabis anti-convulsant shakes up epilepsy treatment


    P.S. I’m a (cigarette) smoker!


    Comment by Phylis Feiner Johnson — September 19, 2013 @ 10:04 AM

  7. Disabled children don’t come from marihuana smoking! That’s the stupidest thing I’ve ever heard. I smoked with both my children, my neuro reduced my pills but told me to stay on marihuana because it’s less harmful to baby.

    The only thing that’s harmful is the smoke, I however used a vaporizer and both my babies are healthy so far. When I read about people being schizo from pot it makes me laugh. FAR more issues and problems from chemicals that we take to keep us from seizing.

    Btw Ritalin and cocaine have the same chemical make up, but Ritalin lasts longer. Yeah., how’s that for our medicial system, just change the name and approve it by the government and your children are doing cocaine by another name. Nice.


    Comment by Camilla — December 18, 2013 @ 2:29 PM

  8. Camilla, perhaps this will calm you down…

    Medical Marijuana — It’s Here To Stay



    Comment by Phylis Feiner Johnson — December 18, 2013 @ 4:01 PM

  9. It’s such a nightmare having psychosis every time I have a seizure now and it never used to happen. It goes on for about three days now and every time I hear anyone mention religion it terrifies me. I’ve only heard voices a couple of times but it really was the scariest thing that ever happened to me


    Comment by Jenny snook — February 22, 2014 @ 4:56 AM

    • Jenny, you’re not crazy. You’re just afraid of the same things — anticipation, fear, and postictal symptoms — many of us experience.

      From what you describe, I think you’re experiencing Postictal Psychosis (PP)

      Postictal psychosis (PP) is a rare but serious complication following seizures, characterized by auditory and visual hallucinations, delusions, paranoia, affective change, and aggression.

      Following the conclusion of the seizure, the patient feels the typical confusion and lethargy of the postictal state, and then gradually recovers to a normal state. This is called the lucid phase.

      In patients who experience PP, the lucid phase usually lasts between 2 hours and a week (usually more than 6 hours) before psychosis sets in.

      In about 12-50% of seizure patients, the lucid phase is followed by a period of psychosis that can last for 12 hours to more than 3 months (the mean is 9–10 days).

      This psychosis is treatable with standard antipsychotic drugs, and stops when the patient no longer experiences seizures.



      Comment by Phylis Feiner Johnson — February 22, 2014 @ 10:50 AM

      • The more I learn the more confusing epilepsy seems. I used to hear things that others didn’t and now realize it was epilepsy related. But, did I hear them before, during or after a seizure – all possible options?

        I’m lucky. Depakote works for me (as long as I don’t eat grapefruit – just discovered that recently) and I’ve decided that as long as seizures, auras, etc. don’t happen, I won’t nitpick the when/why of it all. 🙂

        But, I do like to learn about epilepsy to keep up to date and to help others. Thanks, again, Phylis for this blog from which I have learned so much!

        – Laura


        Comment by Laura M. — February 22, 2014 @ 3:11 PM

  10. You can have more than one aura and more than one type of epilepsy, it’s a wild ride.

    But the more you know, the less you’ll fear, because as they say “Knowledge IS power!”


    Comment by Phylis Feiner Johnson — February 22, 2014 @ 3:53 PM

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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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