Suicide Risk and Antiepileptic Drugs
Some antiepileptic drugs have been associated with an increased risk of suicide. A new study shows that the use of antiepileptic drugs by patients with bipolar disorder did not increase the risk of suicide.
A long-term study of patients with bipolar disorder who took either Tegretol (carbamazepine), Lamictal (lamotrigine), or Depakote (valproate) looked at the suicidal behavior during the time they were taking the drug.
Patients did not show an increased risk of suicide while taking these antiepileptic drugs.
Antiepileptic drugs are used in the treatment of a variety of disorders, including seizure disorders, bipolar disorder, and neuropathic pain.
The Food and Drug Administration (FDA) issued a warning in 2009 about antiepileptic drugs because more suicide behaviors were reported for patients who were taking a variety of antiepileptic drugs, but these reports did not look at patients with bipolar disorder specifically.
A study led by Andrew C. Leon, PhD, reports that the increased suicide attempts or suicide were not found for patients with bipolar disorder who were taking the antiepileptics that are used to treat this disorder - carbamazepine, lamotrigine, or valproate.
The 10 Most Important Bipolar Disorder Facts
There are 10 very important things that you should know about bipolar disorder, due to the complexity of the disease.
- Bipolar disorder is often misdiagnosed as ADHD or Attention Deficit Hyperactivity Disorder.
- Although Bipolar disorder does cause a person to take risks and makes relationships and careers harder, many people who have bipolar disorder and are treated for the condition live happy, successful lives.
- Bipolar disorder can be diagnosed in young children, but it is more commonly diagnosed in teenagers, with the second highest group of people being diagnosed in their early twenties.
- Bipolar disorder is more prevalent in women, but men are not excluded. Research has shown that women who are bipolar tend to cycle between manic and depressive states at a faster rate then men do.
- Bipolar disorder can be inherited, but it does not have to be. The condition can exist even if there isn’t a family history of it, and nobody knows exactly what causes it.
- Bipolar disorder is not exclusive or specific to any race or culture. Everyone is at risk.
- People who have bipolar disorder that go untreated will often ‘self-treat’ without even realizing that this is what they are doing. This self treatment usually involves the use of alcohol or illicit drugs.
- Bipolar is not ‘one size fits all.’ There are different types of bipolar disorder including Bipolar I, Bipolar II, Rapid Cycling, Mixed Bipolar, and Cyclothymia.
- The biggest danger of bipolar disorder is the self destructive side of the condition, in which patients put themselves in harms way or cause themselves bodily injury, such as cutting or self mutilation.
- It takes a great deal of time and effort to properly diagnose bipolar disorder. Typically, the patient has to visit their family doctor, and then they are often referred to a psychiatrist for further evaluation.
The study looked at 199 patients over a 30 year period. The patients were prescribed either carbamazepine, lamotrigine, or valproate at some point during the 30 year observation period. The authors looked at suicide attempts and suicide when patients were taking an antiepileptic and compared it to times when they were not taking an antiepileptic.
Long-term observation of patients on antiepileptics for the treatment of bipolar disorder did not show any link between use of these drugs and increased suicidal behaviors.
dailyRx spoke with Barbara Long, MD, PhD, about the FDA warnings and this new research.
Dr. Long stated, “The FDA has an obligation to the public to warn them about any and all reported adverse reactions and other risks associated with medications, no matter how remote the chance that they will occur. The disclaimers that the public hear in medication advertisements speak to this need to warn.”
“The most prudent advice is to review side effects and risks with your provider and if you feel the risk to harm yourself intensifies, immediately get help.”
The study was published in the March issue of the American Journal of Psychiatry.
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By: Kristi Davis