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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.
January 19th, 2010 at 12:21 pm
I took Topamax for about four years, I am now 43 years old. My dosage was constantly being bumped up due to seizures until I was taking 400mg a day by June ‘09. I also experienced the constant foggyness, trouble forming words, & deminished vision. I have always been a very happy, upbeat, career oriented person. I was now having trouble completing tasks, getting motivated, remembering things, and just being myself. I was on several medications and never really was able to put the blame on any one drug. In Oct of ‘09 I was hit with several personal blows, and for the first time in my life, I didn’t consider my options, I fell into a deep depression, not eating for a couple of weeks and then when I was alone one afternoon, I od’d. I have two children I adore, an extended family that means the world to me, but in that moment, I couldn’t see past my pain. I just want people to see that just because you have safely been on the drug for a couple of years, is not a free pass… Please be careful… I almost lost my life!
January 24th, 2010 at 7:53 pm
I have been on Topamax for just over two years, and I have had fleeting suicidal ideations for the past year. I have also had other side effects with this drug and have wondered whether or not it was worth the benefits. I have brain fog at work, decreased sex drive, tinglinging sensation, mild weight loss, and heart palpitations/problems when exercising. But the depressive thoughts are most disturbing and have caused me to look for other migraine treatment.
February 4th, 2010 at 10:21 am
hi- i was placed on topamax for migraines in july 09, and was basically ok, until i had reached the full dose in the second week in august. i began to cry uncontrollably at everything, and i thought i was going crazy because i couldn’t figure out why on earth i was crying. i had only experienced that with postpartum. any way, i began to have suicidal thoughts-and they seemed like they were just part of my regular thinking-like there was a voice in the background of my brain, chatting away about blowing my brains out w/my husband’s gun. and i was calmly envisioning what my brains would look like on the white tile in my bathroom. i also felt so detached from my family, and that night, as i kissed my little boy good night, i felt NOTHING. so i cried more because i couldn’t understand what was happening. but i was too ?? messed up to figure it out, and too scared to tell my husband, because i was afraid he would have me put away. finally, i told him the next day, and told him i didn’t want to be left alone. he thankfully had the presence of mind to have me stop taking the topamax, since it was the only thing different that could be affecting me. i have NEVER had suicidal thoughts before this! so any way, literally 24 hours later, i was fine! absolutely fine! i so wish the neurologist who put me on this crap would have warned me. i don’t remember seeing anything about it in the package insert. for any of you out there experiencing anything like this, you are not going crazy!! it’s just not the med for you.