Certain anticonvulsants linked to elevated risk of suicide

A new study of prescription and clinical claims data has confirmed that use of certain anticonvulsant medications is associated with increased risk of suicide, attempted suicide or violent death.

In 2008, the Food and Drug Administration mandated warning labeling for anticonvulsants because a meta-analysis found these drugs are linked to increased risk of suicidal thoughts and behaviors. 

But the agency said at the time that data used for the analysis was insufficient to investigate the risk from individual drugs.

In the current study published in the April 14, 2010 issue of JAMA, Elisabetta Patorno, M.D., M.P.H., of Brigham and Women's Hospital and Harvard Medical School, and colleagues evaluated whether individual anticonvulsant medications raise the risk of attempted or completed suicide.

The researchers analyzed data from HealthCore Integrated Research Database covering patients aged 15 and older in 14 states, who started taking an anticonvulsant between 2001 and Dec 2006.

A total of 827 suicidal acts including 801 attempted suicides and 26 completed suicides and additional 41 violent deaths were identified in 297,620 new episodes of treatment with an anticonvulsant.

The researchers found gabapentin, lamotrigine, oxcarbazepine, tiagabine, and valproate increased the risk of suicidal thoughts, compared with topiramate.

"The analyses including violent death produced similar results. Gabapentin users had increased risk in subgroups of younger and older patients, patients with mood disorders, and patients with epilepsy or seizure when compared with carbamazepine," the authors wrote.

Anticonvulsant medications are primarily indicated to treat patients with epilepsy, but also indicated to treat bipolar disorder, mania, neuralgia, migraine and neuropathic pain, according to a press release by JAMA.

By David Liu