Choice of neuroleptics in epilepsy

The decision to use a neuroleptic in people with epilepsy (PWE) depends on the nature of the psychosis being treated. In some cases a neuroleptic is not required and an adjustment of the antiepileptic drug therapy may be all that is necessary. Antiepileptic drug therapy itself can cause psychosis and this, as well as other aetiologies, should be considered. The choice of neuroleptic in PWE depends on: the nature of the patient's psychosis, including the temporal relationship with seizures and/or any relationship to antiepileptic drug therapy; the epileptogenicity of the neuroleptic; antiepileptic drugs; the efficacy of the neuroleptic; and individual tolerability of side-effects.