BACKGROUND: Since the FDA (Food and Drug Administration) report on antiepileptic drugs (AEDs) and suicide risk was released (2008), several studies have been published on this controversial relationship. This systematic review (SR) gives an updated approach to this health issue. SUMMARY: We searched 6 databases. We ultimately included 11 publications: 4 cohort studies, 1 case-crossover study, 2 community case-control studies, and 4 SRs. Overall, 1 SR described studies already included; 3 studies reported a 2- to 4-fold overall increase in risk; 1 study reported an increased risk of suicide among epilepsy patients on AEDs with high risk of depression; 1study showed a protective effect among epilepsy patients; 2 studies were conducted with patients with bipolar disorder (1 showed a protective effect, whereas the other showed a 3-fold increase in risk of suicide), and the other 3 studies reported results for single AEDs. Several biases affected the published results. KEY MESSAGES: There is no clear evidence of an association between the use of AEDs and an increased risk of suicide because of the heterogeneity in the studies at the clinical and methodological level. A future study should cover all indications for use, retrieve information from a healthcare database, and include a defined set of covariates to avoid bias.
BACKGROUND: Since the FDA (Food and Drug Administration) report on antiepileptic drugs (AEDs) and suicide risk was released (2008), several studies have been published on this controversial relationship. This systematic review (SR) gives an updated approach to this health issue. SUMMARY: We searched 6 databases. We ultimately included 11 publications: 4 cohort studies, 1 case-crossover study, 2 community case-control studies, and 4 SRs. Overall, 1 SR described studies already included; 3 studies reported a 2- to 4-fold overall increase in risk; 1 study reported an increased risk of suicide among epilepsypatients on AEDs with high risk of depression; 1study showed a protective effect among epilepsypatients; 2 studies were conducted with patients with bipolar disorder (1 showed a protective effect, whereas the other showed a 3-fold increase in risk of suicide), and the other 3 studies reported results for single AEDs. Several biases affected the published results. KEY MESSAGES: There is no clear evidence of an association between the use of AEDs and an increased risk of suicide because of the heterogeneity in the studies at the clinical and methodological level. A future study should cover all indications for use, retrieve information from a healthcare database, and include a defined set of covariates to avoid bias.
Authors: Ayal Schaffer; Erkki T Isometsä; Leonardo Tondo; Doris H Moreno; Mark Sinyor; Lars Vedel Kessing; Gustavo Turecki; Abraham Weizman; Jean-Michel Azorin; Kyooseob Ha; Catherine Reis; Frederick Cassidy; Tina Goldstein; Zoltán Rihmer; Annette Beautrais; Yuan-Hwa Chou; Nancy Diazgranados; Anthony J Levitt; Carlos A Zarate; Lakshmi Yatham Journal: Aust N Z J Psychiatry Date: 2015-07-16 Impact factor: 5.744
Authors: Jennifer M Boggs; Arne Beck; Sam Hubley; Edward L Peterson; Yong Hu; L Keoki Williams; Deepak Prabhakar; Rebecca C Rossom; Frances L Lynch; Christine Y Lu; Beth E Waitzfelder; Ashli A Owen-Smith; Gregory E Simon; Brian K Ahmedani Journal: Psychiatr Serv Date: 2018-02-15 Impact factor: 3.084
Authors: Olli Nevalainen; Mikko Simola; Hanna Ansakorpi; Jani Raitanen; Miia Artama; Jouko Isojärvi; Anssi Auvinen Journal: Eur J Epidemiol Date: 2015-10-31 Impact factor: 8.082
Authors: Hari K Raju Sagiraju; Chen-Pin Wang; Megan E Amuan; Anne C Van Cott; Hamada H Altalib; Mary Jo V Pugh Journal: Neurol Clin Pract Date: 2018-08