Using anxiolytics in epilepsy: neurobiological, neuropharmacological and clinical aspects

Anxiety disorders represent a common psychiatric comorbidity in patients with epilepsy, affecting prognosis and quality of life. However, they are still underdiagnosed and undertreated. In clinical practice, a number of compounds are currently used as anxiolytics, with benzodiazepines being the most popular. Other drug classes, especially antiepileptic drugs, are increasingly prescribed for the treatment of anxiety. This article discusses the neurobiological targets and basic neuropharmacological aspects of anxiolytics in order to give the reader clear insight into their activity and mechanism of action. Clinical data regarding the treatment of anxiety in both adults and children with epilepsy are also summarised, emphasising the need for further studies.