Anxious about Epilepsy: Simultaneous Treatment of Co-occurring Anxiety and Epilepsy

The interplay between epilepsy and anxiety is complex. Anxiety is associated with fear of seizures, but is also a constituent of epilepsy itself. Treating one could help to improve the other. Both disorders involve dysregulations of the hypothalamic pituitary adrenal axis. Anti-seizure medicines may be well suited to also treat anxiety, namely benzodiazepines. 1,5 benzodiazepines, such as clobazam, are structured differently from those typically prescribed, and may be better tolerated as a result. This is a case of a patient who was socially withdrawn and avoidant, but also had seizures and marked academic disengagement. After clobazam treatment, there was significant improvement in seizure control, anxiety, and social confidence.