title: Activation of suicidal ideation with adjunctive rufinamide in bipolar disorder.
abstract: Antiepileptic drugs are effective psychotropics, especially for bipolar disorder, which leads to their use off-label in treatment-refractory cases. A recent publication suggests that rufinamide may be beneficial adjunctively for bipolar disorder with comorbid psychopathology. This report addresses two negative cases with significant psychiatric adverse effects: increased depression, agitation, and activation of suicidal ideation. These findings suggest that adjunctive rufinamide may lead to increased suicidal ideation in patients with treatment-refractory bipolar disorder. Secondary to the course of severe bipolar disorder, rufinamide cannot be specifically implicated; however, clinicians should be aware of this potential significant adverse effect and monitor high-risk patients. Further studies are required to address rufinamide treatment efficacy and severity of adverse effects in patients with bipolar disorder.
authors.affiliation: Department of Psychiatry, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA. kaufmakr@umdnj.edu
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Kaufman
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Struck
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects; D001714:Bipolar Disorder / Q000523:psychology* / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000379:methods; D005260:Female; D006801:Humans; D013406:Suicide, Attempted / Q000523:psychology*; D014230:Triazoles / Q000009:adverse effects*
chemical_list: D000927:Anticonvulsants; D014230:Triazoles; C079703:rufinamide