TY  - JOUR
PY  - 2010//
TI  - Suicide-related behaviors in older patients with new anti-epileptic drug use: data from the VA hospital system
JO  - BMC medicine
A1  - Van Cott, AC
A1  - Cramer, Joyce A.
A1  - Copeland, Laurel A.
A1  - Zeber, John E.
A1  - Steinman, Michael A.
A1  - Dersh, Jeffrey J.
A1  - Glickman, Mark E.
A1  - Mortensen, Eric M.
A1  - Amuan, Megan E.
A1  - Pugh, Mary Jo
SP  - 4
EP  - 4
VL  - 8
IS  - 1
N2  - BACKGROUND: The U.S. Food and Drug Administration (FDA) recently linked antiepileptic drug (AED) exposure to suicide-related behaviors based on meta-analysis of randomized clinical trials. We examined the relationship between suicide-related behaviors and different AEDs in older veterans receiving new AED monotherapy from the Veterans Health Administration (VA), controlling for potential confounders. METHODS: VA and Medicare databases were used to identify veterans 66 years and older, who received: a) care from the VA between 1999 and 2004, and b) an incident AED (monotherapy) prescription. Previously validated ICD-9-CM codes were used to identify suicidal ideation or behavior (suicide-related behaviors cases), epilepsy, and other conditions previously associated with suicide-related behaviors. Each case was matched to controls based on prior history of suicide-related behaviors, year of AED prescription, and epilepsy status. RESULTS: The strongest predictor of suicide-related behaviors (N = 64; Controls N = 768) based on conditional logistic regression analysis was affective disorder (depression, anxiety, or post-traumatic stress disorder (PTSD); Odds Ratio 4.42, 95% CI 2.30 to 8.49) diagnosed before AED treatment. Increased suicide-related behaviors were not associated with individual AEDs, including the most commonly prescribed AED in the US - phenytoin. CONCLUSION: Our extensive diagnostic and treatment data demonstrated that the strongest predictor of suicide-related behaviors for older patients newly treated with AED monotherapy was a previous diagnosis of affective disorder. Additional, research using a larger sample is needed to clearly determine the risk of suicide-related behaviors among less commonly used AEDs.<p />  <p>Language: en</p>
LA  - en
SN  - 1741-7015
UR  - http://dx.doi.org/10.1186/1741-7015-8-4
ID  - ref1
ER  -