Cognitive and Behavioral Interventions in Epilepsy.

PURPOSE OF REVIEW: Cognitive and behavioral treatments for epilepsy offer several advantages, as they are relatively low cost, are non-invasive, lack serious side effects, and facilitate patient participation. Their role in the management of epilepsy, however, is unclear. The following manuscript will critically review the efficacy data regarding psychological treatments for seizure reduction.

RECENT FINDINGS: Encouraging results have been found for the cognitive behavioral therapy-based Reiter/Andrews approach and mindfulness or arousal-based programs (e.g., yoga, meditation, relaxation, and biofeedback). Most studies attained responder rates between 45 and 90%. Cognitive and behavioral interventions may be considered as low-risk adjuncts to standard therapies. Efficacy data are limited, however, by small numbers of subjects, inadequate randomization, controls, and blinding, brief trial durations, varying methodologies, and variability in the presentation of results. Additional clinical trials are warranted.