People with epilepsy seem to have an increased chance of schizophrenia. In addition, people with schizophrenia seem to have an increased likelihood of epilepsy.
Epilepsy is a neurological condition characterized by recurrent seizures. Roughly
Schizophrenia is a mental health condition that changes the way you feel, think, and behave. It may seem like a person with schizophrenia has lost touch with reality. It’s not clear exactly how common schizophrenia is in the United States, but some estimates hover around
Schizophrenia and epilepsy are distinct conditions, but they seem to occur together at higher rates than either condition appears in the general population. The link seems to be particularly strong with a form of epilepsy called temporal lobe epilepsy.
Read on to learn more about the connection between epilepsy and schizophrenia.
There does seem to be a link between epilepsy and schizophrenia. The link appears to be especially strong among people with a type of epilepsy called temporal lobe epilepsy.
In a 2024 review of studies, researchers estimated the prevalence of psychosis and schizophrenia among people with epilepsy as 8% and 4%, respectively.
Psychosis is one of the hallmark characteristics of schizophrenia. The two main symptoms are hallucinations and delusions. People with epilepsy might also have an increased chance of developing psychosis not due to schizophrenia.
People with temporal lobe epilepsy also seem to have an increased likelihood of developing a condition called schizophrenia-like psychosis of epilepsy (SLPE), also known as
SLPE refers to psychosis that occurs in people with epilepsy within 7 days of a seizure. Typically, it occurs after many years of active temporal lobe epilepsy.
Is there a bidirectional relationship between epilepsy and schizophrenia?
A bidirectional relationship means that each of the two conditions is more common in people with the other condition than in the general population.
The relationship between schizophrenia and epilepsy seems to be bidirectional. Factors that might contribute to the link include:
- shared genetic factors
- both conditions being potential complications of substance misuse
- both conditions being linked to head injuries
- each condition being a side effect of antipsychotic drugs or antiseizure drugs
Genetic factors
It’s thought that shared genetic factors exist between epilepsy and other mental health conditions.
People with epilepsy and their family members seem to have an increased chance of a variety of mental health conditions, including schizophrenia. Research examining which genes might be shared is still in the early stages.
Substance misuse
Substance misuse has been reported as a trigger for epilepsy. Some examples of drugs that may induce seizures include:
- cocaine
- amphetamines and other stimulants
- heroin
- potentially large dosages of caffeine or nicotine, in susceptible people
Also, stopping cannabis use suddenly might be a trigger.
People with schizophrenia also have high rates of substance use disorders, which experts believe affect the course of the condition negatively.
Head injuries
Traumatic brain injury is a risk factor for the development of schizophrenia. Traumatic brain injury is also a well-established risk factor for epilepsy and seizures.
Treatment side effects
Some drugs that treat epilepsy may induce psychosis as a side effect. In addition, some antipsychotic drugs that treat schizophrenia may induce seizures.
An estimated 20% to 30% of people with epilepsy have other mental health conditions. Psychosis is prevalent in about 6% of people with epilepsy, which is almost eight times higher than in the general population.
Epilepsy appears to occur about four to five times more often in people with schizophrenia than in people without schizophrenia.
Having epilepsy and schizophrenia at the same time can make treatment challenging.
Treatment for schizophrenia typically involves taking antipsychotic medications. Some of these medications may induce seizures.
For this reason, doctors may need to be more selective when prescribing antipsychotic medications than they otherwise would need to be.
Schizophrenia is characterized by:
- “positive” symptoms, like:
- hallucinations
- delusions
- unusual thoughts or behaviors
- “negative” symptoms, like:
- losing motivation for everyday activities
- appearing emotionless
- withdrawing from the world
SLPE can cause similar positive symptoms as schizophrenia, but it may tend to cause fewer negative symptoms. People with SLPE may also tend to have lower cognitive deterioration.
About half of children with epilepsy eventually outgrow it. Twenty years later, about 75% of people will be seizure-free for at least 5 years, but some of these people may need to continue taking medications.
The
- having a quick onset of symptoms
- having symptom onset in adulthood
- living in a developed country
- having no history of substance use
- having no cognitive impairment
Having both conditions together can lead to treatment challenges and social difficulties. A closely monitored treatment plan is needed to ensure that treatment is effective for both conditions.
People with temporal lobe epilepsy seem to have an increased chance of developing psychosis and schizophrenia-like symptoms. For these individuals, the psychosis is due to the temporal lobe epilepsy.
SLPE causes similar symptoms to schizophrenia. That said, it may cause less cognitive deterioration and fewer negative symptoms, such as withdrawing or appearing emotionless.
What types of doctors treat epilepsy vs. schizophrenia?
Neurologists typically treat epilepsy. Psychiatrists usually treat schizophrenia.
People with schizophrenia seem to have a higher likelihood of epilepsy, and the opposite also appears to be true. Many factors may contribute to this connection, such as genetic factors and other shared risk factors.
It’s important to seek medical attention promptly if you or your child have either condition. Early diagnosis and treatment tend to improve the outlook for both conditions.