Is antiepileptic-induced suicidality a data-based class effect or an exaggeration? A comment on the literature.
A few years ago the Food and Drug Administration, based on a meta-analysis, issued a warning stating that antiepileptic drugs (AEDs) are associated with an increased risk of suicidal ideation, suicide attempts, and completed suicide. This warning generated significant concern about the use of AEDs, especially in patients with epilepsy and affective disorders. Following the FDA report, several studies addressed this issue but only served to generate further concern and confusion. There seems to be no convincing data concerning a "class effect" of AEDs in inducing any type of suicide-related behaviors. Some data suggest a possible association of lamotrigine, levetiracetam, and topiramate with suicidality, but further research is needed. In any case, clinicians need to carefully assess suicidality in all patients treated with AEDs and inform them and their families on the possible increased risk of suicidality, though preferably in a way that keeps open the continuing use of AEDs.
From the 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki.
Melina
M
Siamouli
Myrto
M
Samara
Konstantinos N
KN
Fountoulakis
D000927:Anticonvulsants / Q000009:adverse effects*; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data
D000927:Anticonvulsants