Question  Does the severity of incident depression influence a patient’s risk of developing epilepsy? Findings  When used as a surrogate for depression severity, analyses stratified by antidepressant treatment type demonstrate a clear, statistically significant gradient in the hazard of epilepsy and the odds of seizure outcomes. Meaning  Using depression treatment as a surrogate of severity, we found that worsening depression appears to augment the risk of epilepsy and the odds of worse seizure outcomes. Future prospective studies designed to address causation between depression and epilepsy are warranted. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai