The US Food and Drug Administration recently issued a warning about AEDs and
suicidality. Pharmaceutical companies performed placebo-controlled trials
with 11 different AEDs, and a 3 year meta-analysis was performed.
With almost 2800 patients in the AED drug arms and 1600 in the placebo arms,
they found that suicidal ideation or attemptive behaviour in the AED drug
arms was 41.8%, and were significantly increased for patients on lamotrigine
(29% of patients in these studies were taking lamotrigine for epilepsy) and
for topiramate (11% of patients were taking topiramate for epilepsy).
Suicidal Ideation significantly increased in patients taking AEDs for
epilepsy, and altogether, there were 34 completed and 1,668 attempted
suicides in people taking AEDs and yet none in the placebo arms.
A study in Iceland investigated Adults and Children over 10 years of age who
developed unprovoked seizures within a period of just over 3 years.
Psychiatric assessments were performed using telephone interviews to arrive
at Diagnostic and Statistical Manual of Mental Disorders-IV diagnoses.
With 324 patients with new onset of seizures and 647 controlled, a history
of major depression was almost twice as common in those with seizures and a
history of a suicide attempt was five times as common in those with seizures
Conclusion
It seems conclusive that the risk of suicide is increased in people with epilepsy, but further studies are needed to identify those more at risk. Claims have been made that suitable treatment may prevent suicides in people with epilepsy and other neurological disorders, but these need to be substantiated.
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