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Antiepileptic Drugs Linked to Increased Risk of Suicidal Behaviors and Thoughts
By Kerrie | January 31, 2008
Patients taking antiepileptic drugs had nearly twice the risk of suicidal behavior or thoughts than those taking a placebo, according to FDA analysis. Epilepsy drugs are commonly prescribed for migraine or headache prevention.
FDA informed healthcare professionals that the Agency has analyzed reports of suicidality (suicidal behavior or ideation) from placebo-controlled clinical studies of eleven drugs used to treat epilepsy as well as psychiatric disorders, and other conditions. In the FDA’s analysis, patients receiving antiepileptic drugs had approximately twice the risk of suicidal behavior or ideation (0.43%) compared to patients receiving placebo (0.22%). The increased risk of suicidal behavior and suicidal ideation was observed as early as one week after starting the antiepileptic drug and continued through 24 weeks. The results were generally consistent among the eleven drugs. The relative risk for suicidality was higher in patients with epilepsy compared to patients who were given one of the drugs in the class for psychiatric or other conditions.
Healthcare professionals should closely monitor all patients currently taking or starting any antiepileptic drug for notable changes in behavior that could indicate the emergence or worsening of suicidal thoughts or behavior or depression.
The drugs included in the analyses include (some of these drugs are also available in generic form):
- Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR)
- Felbamate (marketed as Felbatol)
- Gabapentin (marketed as Neurontin)
- Lamotrigine (marketed as Lamictal)
- Levetiracetam (marketed as Keppra)
- Oxcarbazepine (marketed as Trileptal)
- Pregabalin (marketed as Lyrica)
- Tiagabine (marketed as Gabitril)
- Topiramate (marketed as Topamax)
- Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon)
- Zonisamide (marketed as Zonegran)
Although the 11 drugs listed above were the ones included in the analysis, FDA expects that the increased risk of suicidality is shared by all antiepileptic drugs and anticipates that the class labeling changes will be applied broadly.
I don’t know anything else right now, but will update you when I learn more.
February 1st, 2008 at 7:32 am
I took Topamax for seven days and by the fourth day I was frighteningly depressed and having fleeting suicidal thoughts. I had never felt that way before. I would wake up crying, eat my oatmeal crying, take the dog for a walk crying. At the same time, the Topamax was making me so confused I couldn’t figure out what to do about it. On the seventh day I called the doctor and got permission to stop taking it. The next day all the bad sad feelings were gone, but the confusion lingered for a couple of weeks. Glad to see a study validated my experience. Hope doctors are paying attention.
February 1st, 2008 at 2:52 pm
I tried Topamax for a very short time, as my doctor thought it could help with my chronic daily headaches and migraines. I don’t remember if I was on it just a couple of days, or a week or so… But what I do remember is the feeling of confusion, awful feelings, and the difficulty of remembering words when I spoke… And my mind would race and never rest, and even if my body was exhausted I was hardly able to sleep, because of the activity in my brain. I felt like I was “floating” inches above my bed, even if I knew that wasn’t the fact.. It just literally played with my brain! And then I experienced the first suicidal thought of my whole life.. I surprised myself by thinking that “if I just take enough of these painkillers I won’t feel any pain anymore”…not caring about the fact that if I did that, I also wouldn’t live to see another day! And that woke me up!! Right after realizing what I had been thinking about, I called a friend and she stayed with me through the night. I stopped taking Topamax straight after, and the side affects stopped
Though I did, as Christy posted as well, feel the confusion linger for a while afterwards… It scared me more than anything else I have ever experienced! I feel that I’m a pretty upbeat and cheery person, and despite my chronic headache I don’t have a lot of depression, and suicide has always been the furthest from my mind. Luckily I don’t struggle with that anymore, ever since I stopped with Topamax. I’d rather live WITH headaches, than to not live at all!
~a~
February 3rd, 2008 at 9:28 am
Not to say the FDA shouldn’t keep monitoring this, but remember that drugs work differently on different people. I’ve been taking Topamax for migraine for about two years now, and for the first year it was amazing. Nothing else has ever been so successful at reducing the frequency of my migraines. (I’m 44, and I’ve had migraine since I was about 8 or 9, and I’ve tried many, many remedies.)
February 4th, 2008 at 1:45 pm
Oh my goodness. I hate that ANYONE would have to experience this, but now I feel that I have some validation, also. Thank you, Christy.
I’ve been on my 3rd try with Topamax. I cried at almost everything, got such angry feelings (at times) that I dare not step foot into a Walmart, and experienced depression like I haven’t in a very long time (I’ve been on Welbutrin for many years and have been succesful in treating my depression).
Last night, I had HAD it. I was only taking 25 mg of Topamax (I had been titrating up EVER SO SLIGHTLY) and the side effects were just not an option any more. I didn’t take it last night (for the 1st time in a month) and my sadness, anxiety, and anger have all but disappeared. This is so strange. I sent my neuro an email to let her know I wasn’t going to be taking it anymore. So what does she suggest? She lists several other medications that (she says) shouldn’t have the same side effects, yet when I look them up, they all sound pretty much the same. Zonegran, Neurontin, Lyrica and Keppra. Why do these docs think that if one anti-seizure med messes with my head, that others won’t? I’m so unsatisfied with my treatment, but supposedly, I have one of the best neurologists around.
I wish all of you the best, and if you find something that works… please let me know: serendipity19652003@yahoo.com
Blessings,
Sandi
February 4th, 2008 at 7:35 pm
This is very, very interesting information to me. I’ve struggled with anxiety and depression (and had some fleeting suicidal ideations) but attributed it to some outside factors going on in my life over the past year. Maybe it is the Topamax. It maybe time to give the Topamax a break. Thanks, always, for posting this very helpful information.