Social Stigma and Long-Term Therapeutic Adherence in Epilepsy: Psychosocial Challenges and Clinical Implications

Abstract

Epilepsy is a chronic neurological disorder characterized by recurrent seizures that requires long-term treatment with antiseizure medications. Despite advances in epilepsy management, maintaining therapeutic adherence remains a major global challenge. Social stigma is recognized as an important psychosocial factor contributing to poor medication adherence, emotional distress, social isolation, and reduced quality of life among people with epilepsy. This literature review aimed to evaluate the relationship between social stigma and long-term therapeutic adherence among people with epilepsy, including its psychosocial effects, contributing factors, and potential interventions to improve adherence and treatment outcomes. A literature review was conducted by searching PubMed, Scopus, ScienceDirect, and Google Scholar for articles published between 2016 and 2026. Relevant literature was selected based on its relevance to social stigma, therapeutic adherence, self-management, quality of life, and psychosocial factors in people with epilepsy. The reviewed literature shows that social stigma negatively affects therapeutic adherence. People experiencing stigma often hide their condition, avoid taking medication in public, experience anxiety and depression, and demonstrate poor self-management behaviors. Stigma is also associated with lower quality of life, emotional distress, social withdrawal, and suboptimal medication-related behaviors. Psychosocial interventions, family support, counseling, and educational programs show potential to improve medication adherence and reduce the burden of stigma. Social stigma remains a significant barrier to long-term therapeutic adherence among people with epilepsy. Reducing stigma through multidisciplinary interventions, psychosocial support, counseling, and public education is essential to improve adherence, treatment outcomes, and quality of life.