Comorbidity Burden and Treatment Complexity in Adult-Onset Epilepsy: Insights from a Cross-sectional study in Paraíba, Brazil

Resumo

Background: Epilepsy is a chronic neurological disorder frequently associated with a high burden of psychiatric and systemic comorbidities, which negatively impact prognosis and quality of life. Data from Northeastern Brazil regarding comorbidities and polypharmacy in adult-onset epilepsy remain limited.

Objective: To analyze the clinical and epidemiological profile of patients with epilepsy treated at a tertiary neurology service in Northeastern Brazil, with emphasis on comorbidities, psychiatric conditions, and treatment patterns.

Methods: This was an observational, cross-sectional study including adult patients with epilepsy followed at a tertiary hospital. Clinical, epidemiological, and pharmacological data were analyzed, including number of antiseizure medications, presence of comorbidities, and psychiatric disorders. Descriptive statistics were performed.

Results: The sample was predominantly female (73.3%, n=22), with a median age of 38.5 years (IQR 12.2). Patients presented a mean of 2.3±1.39 comorbidities, with psychiatric disorders observed in 30% (n=9) of cases, mainly anxiety (26.7%, n=8) and depression (20%, n=6). Migraine was also frequent (33.3%, n=10). The median number of antiseizure medications was 2.0 [1.0-2.75], and 26.7% (n=8) of patients met criteria for drug-resistant epilepsy. Polypharmacy was common, with 96.7% (n=29) of patients using additional medications, including antidepressants/anxiolytics (36.7%, n=11), corticosteroids (10%, n=3), and anticoagulants (6.7%, n=2).

Conclusion: Adult patients with epilepsy in this cross-sectional study present a high burden of comorbidities, particularly psychiatric and migraine disorders, along with frequent polypharmacy and a relevant proportion of drug-resistant epilepsy. These conditions negatively affect prognosis, increase healthcare costs, and reduce quality of life. There is a need for further regional studies to better characterize the epidemiology of epilepsy in Northeastern Brazil, supporting more accurate clinical decision-making and improved comprehensive care.