This study assessed the impact of comorbid depression on health care utilization and health care coverage by people with epilepsy in US communities using a postal survey questionnaire. People with untreated depression used significantly more health resources of all types assessed with and without adjustment for seizure type, seizure recency, and days with epilepsy symptoms. The number of visits to medical doctors and psychiatrists differed significantly among people with no (N = 443), mild to moderate (N = 58), and severe (N = 148) symptoms of depression who were not receiving antidepressant treatment (all P < 0.001). People with current symptoms treated with antidepressants had more medical visits than people with no current symptoms ( P=0.016 ). People with current symptoms but not treated for depression had more medical and psychiatric visits than people with no current symptoms (both P = 0.001). These data highlight the impact of comorbid depression on health care utilization by people with epilepsy.