Despite existing warnings that people being treated with antiepileptic drugs have an enhanced suicidal risk, evidence suggests these drugs are not linked to suicide among those with bipolar disorder. In fact recent evidence suggests that epilepsy drugs actually decrease the risk of suicide in people with bipolar disorder.
A report in the December issue of Archives of General Psychiatry focuses on nearly 48,000 bipolar patients in a large medical-claims database. Study author Robert D. Gibbons, Ph.D., of the University of Illinois at Chicago, found that patients who received the antiepileptic drugs had the same number of suicide attempts as those who did not receive such drugs or who received lithium.
Digging a little deeper, Gibbons and colleagues discovered that patients treated with antiepileptic drugs had far more suicide attempts before treatment than those not treated with the drugs. Put another way, those treated with antiepileptic drugs had a lower rate of suicide attempts after treatment.
The backdrop to the issue stems from an alert by the Food and Drug Administration in January 2008. The FDA warned there was a significant positive association between antiepileptic drugs and suicidal thoughts, but voted against placing a black box warning on antiepileptic drugs. People with bipolar disorder have a higher than average risk of suicide and Gibbons data suggests those with more severe bipolar disorder are more likely to be treated with antiepileptic drugs.
At the time of the alert there were some doubts about whether bipolar patients being treated with antiepileptic drugs should be included. The news that antiepileptic drugs may have a protective effect against suicide is encouraging. Gibbons data points to a suicide rate attempt of 72 per 1,000 prior to treatment with antiepileptic drugs, dropping to 13 per 1,000 after treatment.
Sources:
JAMA and Archives Journals (2009, December 10). Antiepileptic drugs not linked to suicide among those with bipolar disorder. ScienceDaily. Retrieved Decemeber 31, 2009, from http://www.sciencedaily.com/releases/2009/12/091207164852.htm
