skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8838

Antiepileptic drugs and suicidality

Review

(2256) Views  (542) Full article downloads

Authors: Jeffery W Britton, Jerry J Shih

Published Date September 2010 Volume 2010:2 Pages 181 - 189
DOI: http://dx.doi.org/10.2147/DHPS.S13225

Jeffery W Britton1, Jerry J Shih2
1Mayo Clinic, Rochester, MN, USA; 2Mayo Clinic, Jacksonville, FL, USA

Abstract: The risk of suicide in patients with epilepsy is significantly higher than the general population. There are many hypotheses as to the reasons for this, but the potential role of antiepileptic drugs (AEDs) in increasing suicidality has recently been brought into question. In 2008, the U.S. Food and Drug Administration (FDA) published a warning after a meta-analysis of data from all clinical trials involving AEDs found a suicidality risk of 0.43 per 1000 patients in active drug arms of these clinical trials compared to a rate in the placebo arm of 0.22. While an increased risk for individual AEDs was found in two, the FDA decided to issue a warning for the entire AED class. While this decision and the meta-analysis findings have been considered controversial, and have created concern that this stated risk may dissuade use of AEDs by patients who would benefit from them, it has led to increased awareness of the risk of suicidality and psychiatric co-morbidity in this patient group. In this article, the association of epilepsy and AEDs with psychiatric disease and suicidality are reviewed, perspective as to the significance and limitations of the FDA’s findings are discussed, and some options for suicidality screening and their potential utility in clinical care are evaluated.

Keywords: antiepileptic drugs, suicidality, FDA, behavior






Readers of this article also read:

Gamma knife radiosurgery for uveal melanoma ineligible for brachytherapy by the Collaborative Ocular Melanoma Study criteria
Periosteoplasty for covering gingival recessions: Clinical results
Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors
Exacerbation rate, health status and mortality in COPD – a review of potential interventions
Information technology in pharmacovigilance: Benefits, challenges, and future directions from industry perspectives
Functional mobility and balance in community-dwelling elderly submitted to multisensory versus strength exercises
Phosphodiesterase-5 inhibitors in management of pulmonary hypertension: Safety, tolerability, and efficacy
Erratum - Intracellular heavy metal nanoparticle storage
Improvement of adenoviral vector-mediated gene transfer to airway epithelia by folate-modified anionic liposomes
Erratum
  • Testimonials

    "You do a tremendous job!!" Ruben Restrepo, The University of Texas Health Science Center at San Antonio