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Epilepsy and Psychosis

By Brenda Marshall posted 07-23-2020 07:40 PM

  
Welcome to the APNA research blog, which will focus on how evidence based practice can be best applied to psychiatric nursing.  I’m Brenda Marshall, a PMHNP, a university professor and a life-long lover of evidence!  I hope you will join us each month for this blog on utilizing research in the delivery of Psychiatric Nursing.   You might be asking, "Why should we, the psychiatric nurses of America, care so much about research?".  The answer is because it is the only way we can assure that our patients/clients receive the best care providing them with the greatest capacity for recovery.  Take for example the subject of seizures and psychosis.  Most people are not aware that between 6-10% of people with epilepsy have postictal psychosis sometime  during the seven days past seizure (Epilepsy foundation) and people with epilepsy are 8 times more likely to develop schizophrenia than those without epilepsy.   I recall a patient I worked with who had schizophrenia but who appeared to be having partial complex seizures.  According to research, persons with schizophrenia are six times more likely to develop epilepsy and the symptoms might be masked as symptoms of their psychiatric diagnosis delaying treatment. As clinicians we are aware of how hard it is to get a person with delusions and hallucinations to undergo a 24 or 48 hour EEG, but understanding what medications can be used to decrease seizure activity can help our patients on their way to recovery.  With this particular patient, in order to get more people on board with the possibility of a seizure disorder, I held a journal club and provided three articles on epilepsy in persons with schizophrenia.  This approach  started a conversation and eventually led to the patient receiving Lamotrigine, which demonstrated efficacy in controlling the seizure activity that was seriously impeding his pathway to recovery.  Research matters, evidence based practice matters, curiosity matters – “Knowing” can sometimes be the enemy of “learning”.  Research helps us learn.  I look forward to hearing your comments!   Welcome to the APNA research blog!
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