title: Report of the WPA section of pharmacopsychiatry on the relationship of antiepileptic drugs with suicidality in epilepsy.
abstract: BACKGROUND
  This report from the World Psychiatric Association Section on Pharmacopsychiatry examines the possible relationship of antiepileptic drugs with suicide-related clinical features and behaviors in patients with epilepsy.
  
  
  METHODS
  A systematic review of the MEDLINE search returned 1039 papers, of which only 8 were considered relevant. A critical analysis of the Food and Drug Administration (FDA) report on the increase risk for patients under antiepileptics to manifest suicidality is also included in this report.
  
  
  RESULTS
  The analysis of these studies revealed that the data are not supportive of the presence of a "class effect" on suicide-related behavior; on the contrary, there are some data suggesting such an effect concerning treatment with topiramate, lamotrigine, and levetiracetam for which further research is needed.
  
  
  CONCLUSIONS
  For the majority of people with epilepsy, anticonvulsant treatment is necessary and its failure for any reason is expected to have deleterious consequences. Therefore, clinicians should inform patients and their families of this increased risk of suicidal ideation and behavior, but should not overemphasize the issue. Specific subgroups of patients with epilepsy might be at a higher risk, and deserve closer monitoring and follow-up. Future research with antiepileptics should specifically focus on depression and suicidal thoughts.
authors.affiliation: a 3rd Department of Psychiatry , School of Medicine , Aristotle University of Thessaloniki , Greece.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Fountoulakis
authors.forename: Xenia
authors.initials: X
authors.lastname: Gonda
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Baghai
authors.forename: David S
authors.initials: DS
authors.lastname: Baldwin
authors.forename: Michael
authors.initials: M
authors.lastname: Bauer
authors.forename: Pierre
authors.initials: P
authors.lastname: Blier
authors.forename: Wagner
authors.initials: W
authors.lastname: Gattaz
authors.forename: Gregor
authors.initials: G
authors.lastname: Hasler
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.forename: Rajiv
authors.initials: R
authors.lastname: Tandon
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects*; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D012307:Risk Factors; D013405:Suicide; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptics; anticonvulsants; suicidality