Not only can epilepsy and bipolar disorder affect each other, but the treatments for these conditions can sometimes have an adverse effect on the other.

Epilepsy is a neurological condition — or a condition affecting the brain — that causes someone to experience recurrent seizures. Seizures develop when there are changes in the electrical activity of the brain, resulting in alterations in body movements, sensations, consciousness, and more.

Although epilepsy isn’t a mental health condition, there’s a wide array of evidence that suggests that people with epilepsy are more likely to experience mood disorders. In fact, one of the most commonly co-occurring mood disorders in people with epilepsy is bipolar disorder.

Below, we’ll explore more about the relationship between epilepsy and bipolar disorder, including treatment options to consider and where to find support if you live with both of these conditions.

It’s well known that people who have epilepsy are more likely to live with co-occurring mental health conditions. Current research on epilepsy and bipolar disorder suggests a significant relationship between the two conditions.

One study from 2022 explored the potential link between having a family history of certain diseases and bipolar disorder. The results of the study found that there was a significant correlation between a family history of epilepsy and bipolar disorder featuring psychotic symptoms.

Another systematic review published in 2021 analyzed the prevalence of mental health conditions in adults with epilepsy.

According to the review, the prevalence of mood disorders in adults with epilepsy was 35%. Bipolar disorder was among the most common disorders, affecting roughly 6.2% of study participants — with a higher risk of these conditions in those with temporal lobe epilepsy.

In a more recent meta-analysis from 2022, researchers explored the rates of both bipolar symptoms and bipolar disorder in epilepsy. Study results showed a prevalence of 12.3% for bipolar symptoms and 4.5% for bipolar disorder in study participants with epilepsy.

One of the reasons why epilepsy and bipolar disorder may be more likely to co-occur is because of underlying changes in the brain. According to research, there are similar changes in certain neurotransmitters, pathways, and other brain processes that occur in both conditions.

Another possible factor in the relationship between these conditions is treatment. For example, some epilepsy medications may cause mood changes or possibly even worsen manic or depressive symptoms in those with bipolar disorder.

Can a seizure trigger a manic episode?

Some research suggests that seizures or seizure-like activity in the brain may contribute to manic symptoms and episodes in people with bipolar disorder.

One study from 2020 explored the effect of possible epileptic brain activity on symptoms of bipolar disorder.

Study results showed that participants who experienced brain changes related to possible seizure activity had more hypomanic episodes per year. Results also indicated that this type of brain activity was associated with more hypomania episodes than depressive episodes.

Ultimately, while studies are limited, research on epilepsy and manic episodes does suggest that a small percentage of people with both conditions will experience mania before or after a seizure.

When it comes to treating both epilepsy and bipolar disorder, there are some important considerations regarding the medications used to treat these conditions.

Medications for epilepsy

Antiepileptic drugs (AEDs), also known as antiseizure medications, are the primary treatment approach for epileptic seizures. AEDs are categorized as either narrow-spectrum or broad-spectrum:

  • Narrow-spectrum AEDs: These target specific types of seizures that happen in specific parts of the brain.
  • Broad-spectrum AEDs: These target seizures that affect more than one or multiple parts of the brain.

Although antiseizure medications primarily treat epilepsy, three AEDs can actually help treat the symptoms of bipolar disorder in people without epilepsy: valproic acid, carbamazepine, and lamotrigine.

Outside of these medications, there are several AEDs that can possibly make mental health symptoms worse: levetiracetam, topiramate, and perampanel. According to research, these medications may increase the risk of aggression, depression, and psychosis.

Because of the potential impact that AEDs can have on mental health symptoms, it’s important to consider the benefits and risks of these drugs in people with bipolar disorder. Talk with your doctor if you have concerns about the side effects of any of your medications.

Medications for bipolar disorder

Several medication options can help treat the symptoms of bipolar disorder, including:

While these medications are effective at treating bipolar disorder, research suggests that several of them may increase seizure risk, including bupropion, certain tricyclic antidepressants, maprotiline, and clozapine.

Similar to the risk of side effects from AEDs in people with bipolar disorder, it’s also important to consider the increased risk of seizures in people taking bipolar disorder medications. Always important to make sure your doctor is aware of your full health history, especially if you’re working with a new healthcare professional.

Therapeutic treatments for bipolar disorder

While medication can be invaluable in regulating bipolar disorder, some studies show that results are improved for those who combine medication with psychotherapy.

In therapy, you’ll learn tools to help regulate your emotions, promote healthy self-expression, and strategies to ensure that you take your medication regularly — which can be beneficial for both epilepsy and bipolar disorder.

Learn more about therapeutic treatments for bipolar disorder in these articles:

Whether you live with epilepsy, bipolar disorder, or both, there are resources that can help you learn more about treatment and how to better manage your conditions:

Research shows that people who have epilepsy are more likely to be diagnosed with mood disorders, including major depressive disorder and bipolar disorder. Research also suggests that people with bipolar disorder are at an increased risk of experiencing or developing seizures.

If you live with epilepsy and bipolar disorder, treatment can help you manage the symptoms of both of these conditions and improve your overall quality of life.