Antiepileptic drugs suicidality

There have been several studies of whether antiepileptic drugs increase the risk of suicide, with conflicting results, and the subject has been widely discussed [55, 56, 57, 58, 59, 6(T,6r,6r,63 , 64 ]. 

The association between the use of antiepileptic drugs and suicide-related events (attempted suicide and completed suicide) in patients with epilepsy, depression, or bipolar disorder has been studied in 5130 795 patients [66 ]. The incidence of suicide-related events per 100 person-years was 15 among patients without epilepsy, depression, bipolar disorder, or antiepileptic drug treatment, 382 among patients with epilepsy who did not take antiepileptic drugs, and... 

Mula M, Sander JW. Antiepileptic drugs and suicide risk could stopping medications pose a greater hazard Expert Rev Neurother 2010 10(12) 1775-6. 

Pompili M, Baldessarini RJ. Epileps5c risk of suicidal behavior with antiepileptic drugs. Nat Rev Neurol 2010 6(12) 651-653. 

Ziemba KS, O Carroll CB, Drazkowski JF, Wingerchuk DM, Hoffman-Snyder C, Wellik KE, Demaeischalk BM. Do antiepileptic drugs increase the risk of suicidality in adult patients with epilepsy A critically appraised topic. Neurologist 2010 16(5) 325-8. 

Mula M, Bell GS, Sander JW. Suicidality in epilepsy and possible effects of antiepileptic drugs. Curr Neurol Neurosd Rep 2010 10(4) 327-32. 

Craven R. Antiepileptic drugs and suicid-aUty finding ways forward. Lancet Neurol 2010 9(6) 568-9. 

Gibbons RD, Hur K, Brown CH, Mann JJ. Antiepileptic drugs and suicide attempts in patients with bipolar disorder—reply. Arch Gen Psychiatry 2010 67(12) 1326-7. 

Zebley BD, Ferrando SJ. Suicide-related events in patients treated with antiepileptic drugs. N Engl J Med 2010 363(19) 1873. 

Olesen JB, Hansen PR, Erdal J, Abildstrpm SZ, Weeke P, Fosbpl EL, Poulsen HE, Gislason GH. Antiepileptic drugs and risk of suicide a nationwide study. Pharmacoepidemiol Drug Saf 2010 19(5) 518-24. 

Andersohn F, Schade R, Willich SN, Garbe E. Use of antiepileptic drugs in epilepsy and the risk of self-harm or suicidal behavior. Neurology 2010 75(4) 335-40. 

VanCott AC, Cramer JA, Copeland LA, Zeber JE, Steinman MA, Dersh JJ, Glickman ME, Mortensen EM, Amuan ME, Pugh MJ. Suicide-related behaviors in older patients with new antiepileptic drug use data from the VA hospital system. BMC Med 2010 8 4. 

Wen X, Meador KJ, Loring DW, Eisenschenk S, Segal R, Hartzema AG. Is antiepileptic drug use related to depression and suicidal ideation among patients with epilepsy Epilepsy Behav 2010 19 (3) 494-500. 

Up to a few years ago, the association between the risk of suicidal ideation and behavior and the use of antiepileptic drugs had been explored in very few studies. In an observational study of 517 consecutive patients taking levetiracetam, four (0.7%) reported suicidal ideation [Id ]. The incidence of suicidal ideation and behavior resulting from antiepileptic drug exposure in clinical trials is unknown, because most published data group all psychiatric adverse events together rather than reporting suicidality by itself [15, 16, 17 ]. 

In 2005, in a sponsor s report of a doubleblind study, there was a slightly higher risk of suicidality in the antiepileptic drug-treated patients compared with those taking placebo and there were also reports of suicidality related to the branded formulation of gaba-pentin [18 ]. 

These data prompted the US Food and Drug Administration (FDA) to reanalyse all data on the risk of suicide in controlled studies of antiepileptic drugs. 

It has also been considered that although the question of suicidality with these drugs is controversial, the adverse effects of failing to control epilepsy are not. If antiepileptic drugs are less frequently prescribed or taken, seizure control may worsen, with associated increases in accidents and mortality, or sudden unexplained death from seizures [20 ]. In a large study of people with epilepsy it has been reported that 21 % had an accident... 

The reaction of neurologists to the FDA alert concerning suicidal ideation or behavior and antiepileptic drugs has been explored in a study of 175 of 780 participants who answered a questionnaire via e-mail on the approach to suicidality and depression in patients with epilepsy [37 ]. Although 98% warned about behavioral adverse effects when starting antiepileptic drugs, only 44% warned specifically about suicidal ideation or behavior. More than half were not aware of patients who attempted to commit suicide or who had committed suicide. 

Hesdorffer DC, Kanner AM. The FDA alert on suicidality and antiepileptic drugs fire or false alarm Epilepsia 2009 50(5) 978-86. 

Center for Drug Evaluation and Research, Office of Translational Sciences, Office of Biostatistics. Statistical Review and Evaluation Antiepileptic Drugs and Suicidality. 2008 May 21, 2008. 

Janati A, Shneker BE, Qos JS, Elliott JO. Suicidality, depression screening, and antiepileptic drugs reaction to the FDA alert. Neurology 2009 73(20) 1710. 

Bell GS, Mula M, Sander JW. Suicidality in people taking antiepileptic drugs what is the evidence CNS Drugs 2009 23(4) 281-92. 

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