Alternative psychosis and forced normalization

In some patients periods of seizure control and normalized EEG appear to be associated with the development of psychoses, which is reversed when seizures recur (the phenomenon as applied to EEG is sometimes known as 'forced normalization'). However, the opposite pattern is also observed, and the true status of forced normalization is rather contentious. The exact mechanism of this pattern is unclear. Antipsychotics, antidepressants and anxiolytic drugs, as appropriate, can be used to treat these episodes. In some individuals the psychosis may be due in part to the introduction of an antiepileptic drug (associated with the remission of seizures), and the replacement of this drug by others is worthwhile. In exceptional cases it is deemed better to allow seizures to continue rather than risk psychotic breakdown.

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