Suicide-Related Events in Patients Treated With Antiepileptic Drugs
Arana A, Wentworth CE, Ayuso-Mateos JL, Arellano FM N Engl J Med. 2010;363:542-551
Based on a meta-analysis of clinical trial data, use of antiepileptic drugs has previously been linked to suicidal ideation and/or behavior. Using observational data collected during clinical care of 5,130,795 patients representative of the general UK population, this study looked at the association between the use or nonuse of antiepileptic drugs and suicide-related events, which were defined as attempted or completed suicides in patients with epilepsy, depression, or bipolar disorder. ...
Adjustment using logistic regression analysis showed that the use of antiepileptic drugs was not associated with an increased risk for suicide-related events among patients with epilepsy (odds ratio [OR], 0.59; 95% CI, 0.35-0.98) or bipolar disorder (OR, 1.13; 95% CI, 0.35-3.61). However, the use of antiepileptic drugs was associated with a significantly increased risk for suicide-related events in patients with depression (OR, 1.65; 95% CI, 1.24-2.19), as well as in patients without epilepsy, depression, or bipolar disorder (OR, 2.57; 95% CI, 1.78-3.71).
http://www.medscape.com/viewarticle/727156
From Dr. Rotenberg - This is exciting news for people who have to take anti-convulsants for epilepsy. The article did not find an association between suicide-related events and the use of anti-seizure medications. On the other hand, I would caution readers from infering that there is a protective efffect of anti-convulsant use. The odds ratio of .59 might lead one to conclude that the risk of suicide was lower and that the medications are protective. Despite the indications of this number, please recall that this is a single statistic and that the study was not designed to show this inverse relationship.
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