Anticonvulsants increase suicide risk

By Candy Lashkari

Dr. Elisabetta Patorno, a research fellow at Brigham and Women's Hospital and Harvard Medical School in Boston has published a study this week in the Journal of American Medical Association which found that taking anticonvulsant drugs raise thoughts of suicide and risks of actually trying to commit suicide by two times the norm.

The study was sponsored by the Harvard School of Public Health and HealthCore, a research subsidiary of WellPoint. WellPoint is a health benefits company that serves the Blue Cross Blue Shield network.

It has been pointed out by the FDA in an earlier study and Dr Patorno’s study also found this to be true. The study group led by Dr Partorno focused on the HealthCore Integrated Research Database which maintains records of prescriptions and adverse side effects. They were studying almost 300,00 patients in the above 15 age group in 14 states. These patients had begun taking anticonvulsant medication between July 2001 and December 2006.

In the corresponding period the researchers identified 801 attempted suicides, 26 completed suicides and 41 violent deaths amongst the patients. This was a total of 868 combined suicidal acts of patients on anticonvulsant drugs. It has also been suggested that the patients on these drugs are more likely to be suicidal than the average population. The drugs are essentially used to control epileptic seizures, but more psychiatrists are using them to treat other conditions like bipolar disorder, mania, migraine and chronic nerve pain.

"Anticonvulsant medications have important therapeutic benefits, but they also have associated risks that both provider and patient need to remain aware of," said Dr. Elisabetta Patorno

“Physicians should discuss associated risks and benefits with their patients, and together determine the best treatment course for the underlying medical condition," she Dr Patorno. "Both patients and health-care professionals should be alert to early symptoms that might potentially be associated with suicidal risk.”

In response to the study findings Dr. Orrin Devinsky, director of the Epilepsy Center at NYU Langone Medical Center said, “I do not think that the results should affect physician behavior at this time. Anti-epileptic drugs are used primarily in patients with epilepsy and patients with psychiatric disorders; both groups have well-known increased risk for suicidal behavior. The question is if there was a bias with regards to patients selected on these medications, and also whether these results, which were statistically significant, would be replicated and have clinical significance.”

Another opinion cited that the study may be misleading. Dr. Ewald Horwath, a professor of psychiatry & behavioral sciences at the University of Miami Miller School of Medicine said, “The study did not take adequate account of why people were taking the anticonvulsant. Many of the people in the study were taking these drugs to treat bipolar disorder and depression. Conditions that are associated with higher suicide rates. Another study of patients with bipolar disorder found these drugs actually decreased the risk for suicide”

Another study on why and how the drugs are being prescribed will be needed to check if these drugs do indeed increase the risk of suicidal tendencies in patients taking them.