Psychiatric disorders in epilepsy have a multifactorial etiology, being pharmacotherapy only one of many risk factors, which can be both biological and psychosocial. The adverse effects of antiepileptics (AEDs) embrace all categories of psychiatric symptomatology, including disturbances of consciousness, psychotic state, neurotic state, behaviour and character disorder. In fact, Psychotropic effects of AEDs require further research because many relevant parameters related to pathological mechanisms, frequency, psychopathology, and prognosis are not well understood.

The authors aim to present a case of an adolescent with epilepsy who has developed secondary psychiatric symptoms.

To understand and deal with the most common Psychiatric side effects of AEDs.

A non-systematic review of English scientific literature was conducted using keywords “Epilepsy” and “antiepileptic side effects”.

A 14-year-old female adolescent with history of seven years of Epilepsy (usual medication: carabamazepine 45 mg/kg/day, Lamotrigine 8 mg/kg/day; pregabaline 8 mg/kg/day) was admitted in the paediatric ward due to behaviour disorder characterized by agitation, anxiety and seizures-like symptoms. A therapeutic adjust was made (Fenetoíne and Levetiracetam). After this medication change, the adolescent presented psychotic symptoms namely auditory and tactile hallucinations. A complete clinical investigation was performed and the hypothesis of drugs side effects was considered. After AEDs reduction, a total remission of the symptoms was obtained.

Psychiatric disorders in epilepsy have a multifactorial etiology and are not yet well understood. Behavioural side-effect profiles of AEDs (both negative and positive effects) should be considered in the choice of the optimal drug for each patient.

The authors have not supplied their declaration of competing interest.