Psych CASC / OSCE · Consultation-liaison psychiatry
Explaining postictal psychosis and depression treatment to a partner — CASC communication station
MRCPsych/FRANZCP-style station: explain postictal psychosis, lucid interval, safety, AED role including possible behavioural side effects without scapegoating all treatment, and rationale for treating interictal depression.
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Station brief
Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar. Neurology remains involved. You meet the partner alone first.[1]
Candidate instructions. Explain postictal psychosis in plain language, including the lucid interval and why this is not ordinary "madness from stress." Address fear about AEDs honestly (some can affect mood/behaviour; stopping all AEDs abruptly is dangerous). Explain why depression screening/treatment matters and that carefully chosen antidepressants (often SSRIs) are commonly used in epilepsy. Agree a shared safety and follow-up plan. Avoid inventing legal section numbers.[2][4]
References5ShowHide
- [1]Logsdail SJ, Toone BK Post-ictal psychoses. A clinical and phenomenological description Br J Psychiatry, 1988.PMID 3167343
- [2]Barry JJ, Ettinger AB, Friel P, et al. Consensus statement: the evaluation and treatment of people with epilepsy and affective disorders Epilepsy Behav, 2008.PMID 18502183
- [3]Gilliam FG, Barry JJ, Hermann BP, et al. Rapid detection of major depression in epilepsy: a multicentre study Lancet Neurol, 2006.PMID 16632310
- [4]Mula M Epilepsy and Psychiatric Comorbidities: Drug Selection Curr Treat Options Neurol, 2017.PMID 29046989
- [5]Maguire MJ, Marson AG, Nevitt SJ Antidepressants for people with epilepsy and depression Cochrane Database Syst Rev, 2021.PMID 33860531