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a more significant form of depression, with sustained mood changes and negative thoughts
about the world and future. This may require more formal support including antidepressants
and/or counselling. Admission to hospital is rarely required. A minority of patients may
develop a psychosis post-surgically. Relatives are counselled that if they notice a difference
in the patient’s mood causing concern they should report it to the clinician concerned.

It is important that the patient appreciates that antiepileptic medication needs to be continued
after surgery. The counsellor will ensure that the patient understands that no changes in
medication will normally be made for the first 12 months and the aims of surgery will
normally have been achieved within two years.