Patients with epilepsy are at high risk for psychiatric disorders because of an incompletely understood combination of factors that may be both psychosocial and neurological. One of the most important issues in treating this group of patients with anxiety, psychotic or mood disorders is the safety of psychotropic drugs, as far as their epileptogenic potential. Interictal psychiatric disorders in patients with epilepsy is an undertreated condition, in part because of concern regarding drug interactions and the risk of exacerbating seizures. Although this phenomenon has been described with almost all the available compounds, neither its real magnitude nor the seizurogenic potential of individual drugs have been clearly established so far. Seizures triggered by psychotropic drugs are a dose- dependent adverse effect. Among antidepressants bupropion, maprotiline, and clomipramine and among antipsychotics chlorpromazine and clozapine have a relatively high seizurogenic potential. The problem may be minimised through careful evaluation of the possible presence of seizurogenic conditions and rational strategies such as slow dose escalation, maintenance of the minimal effective dose, and avoidance of complex drug combinations. Further scientific research is warranted to clarify all aspects characterising the complex link between seizure mechanism and psychotropic drugs.