Citation

Fountoulakis KN, Gonda X, Baghai TC, Baldwin DS, Bauer M, Blier P, Gattaz W, Hasler G, Möller H, Tandon R, Vieta E, Kasper S. Int. J. Psychiatry Clin. Prac. 2014; 19(3): 158-167.

Copyright

(Copyright © 2014, Informa - Taylor and Francis Group)

DOI

10.3109/13651501.2014.1000930

PMID

25547437

Abstract

Introduction This Report from the WPA Section on Pharmacopsychiatry examines the possible relationship of antiepileptic drugs with suicide-related clinical features and behaviours in patients with epilepsy. Material and methods A systematic review of the MEDLINE search returned 1039 papers, of which only 8 were considered relevant. A critical analysis of the 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 behaviour; on the contrary there are some data suggesting such an effect concerning treatment with topiramate, lamotrigine and levetiracetam for which further research is needed.

DISCUSSION 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 sub-groups 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.

Language: en