Report of the WPA section of pharmacopsychiatry on the relationship of antiepileptic drugs with suicidality in epilepsy

Konstantinos N. Fountoulakis, Xenia Gonda, Thomas C. Baghai, David S. Baldwin, Michael Bauer, Pierre Blier, Wagner Gattaz, Gregor Hasler, Hans Jürgen Möller, Rajiv Tandon, Eduard Vieta, Siegfried Kasper

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Introduction. This report from the World Psychiatric Association Section on Pharmacopsychiatry examines the possible relationship of antiepileptic drugs with suicide-related clinical features and behaviors in patients with epilepsy. Materials and methods. A systematic review of the MEDLINE search returned 1039 papers, of which only 8 were considered relevant. A critical analysis of the Food and Drug Administration (FDA) report on the increase risk for patients under antiepileptics to manifest suicidality is also included in this report. Results. The analysis of these studies revealed that the data are not supportive of the presence of a "class effect" on suicide-related behavior; on the contrary, there are some data suggesting such an effect concerning treatment with topiramate, lamotrigine, and levetiracetam for which further research is needed. Discussion. For the majority of people with epilepsy, anticonvulsant treatment is necessary and its failure for any reason is expected to have deleterious consequences. Therefore, clinicians should inform patients and their families of this increased risk of suicidal ideation and behavior, but should not overemphasize the issue. Specific subgroups of patients with epilepsy might be at a higher risk, and deserve closer monitoring and follow-up. Future research with antiepileptics should specifically focus on depression and suicidal thoughts.

Original languageEnglish
Pages (from-to)158-167
Number of pages10
JournalInternational Journal of Psychiatry in Clinical Practice
Volume19
Issue number3
DOIs
Publication statusPublished - Jul 3 2015

Keywords

  • Antiepileptics
  • anticonvulsants
  • suicidality

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Fountoulakis, K. N., Gonda, X., Baghai, T. C., Baldwin, D. S., Bauer, M., Blier, P., Gattaz, W., Hasler, G., Möller, H. J., Tandon, R., Vieta, E., & Kasper, S. (2015). Report of the WPA section of pharmacopsychiatry on the relationship of antiepileptic drugs with suicidality in epilepsy. International Journal of Psychiatry in Clinical Practice, 19(3), 158-167. https://doi.org/10.3109/13651501.2014.1000930