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Antiepileptic Drugs Not Associated with Higher Suicide Risk in Patients with Bipolar Disorder

Contrary to the FDA's assertions, antiepileptic drugs do not appear to be associated with increased risk for suicide attempts — at least among patients with bipolar disorder — the Archives of General Psychiatry reports.

Using medical claims data, researchers examined suicide attempts 1 year before and after diagnosis of bipolar disorder in nearly 50,000 patients. After diagnosis, the patients received monotherapy with an antiepileptic or lithium; neither drug; or no CNS-acting medication at all.

Suicide attempt rates of patients on an antiepileptic (13 per 1000 person-years) or lithium (18) were comparable to the rate among patients not receiving any drug (13). When looked at individually, however, the antiepileptics carbamazepine and topiramate were associated with higher attempt rates relative to no therapy. Rates after treatment with any antiepileptic were lower than pretreatment rates.

The authors acknowledge several limitations in their study, but conclude that the analysis "provides no evidence that [antiepileptics] increase risk of [suicide attempts] in patients with bipolar disorder."

LINK(S):

Archives of General Psychiatry article (Free abstract; full text requires subscription)

Physician's First Watch coverage of FDA warning (Free)

Published in Physician's First Watch December 8, 2009