Epilepsy drugs scrutinized over provoking suicidal thoughts

The Food and Drug Administration may soon order the makers of 11 epilepsy drugs to warn users about potential suicidal behavior, the Wall Street Journal reported Wednesday. According to an alert published by the FDA in January, patients receiving anti-epileptic drugs, such as Tegretol, Neurontin and Lyrica, had about twice the risk of suicidal behavior and thoughts compared with patients taking a placebo. The alert states:

"All patients with anti-epileptic drugs should be monitored for suicidality and other unusual changes in behavior. Symptoms such as anxiety, agitation, hostility, mania and hypomania may be precursors to emerging suicidality."

The 11 medications that may be included in the mandate can be found here.

This development points out a couple of things. One, the FDA is plenty serious about warning consumers of the potential for psychiatric side effects from medications. Recently, the agency warned that the anti-smoking drug Chantix could cause suicidal thoughts. It should be no surprise that some drugs cause psychiatric symptoms as well as physical symptoms, such as an upset stomach or weight gain. The brain is just as sensitive to the effects of medication as other organs and tissues --perhaps more so.

As noted by In Vivo Blog: "Over the long term, manufacturers would be wise to take a cautious approach to psychiatric drug safety. FDA certainly is."

Second, it will be interesting to see how the warnings affect other areas of medicine. Anti-epileptic medications are used to treat a host of conditions besides epilepsy. For example, in recent years psychiatrists have taken a big interest in using medications such as Tegretol and Depakote to treat serious mental health disorders. Some of the drugs appear to be effective, especially for treating bipolar disorder. But there are very few studies that show which anti-epileptic medications might be more effective for certain psychiatric conditions. I also wonder how the suicide risk (which was found mainly in people taking epilepsy drugs for epilepsy) will play out in a population of people with mental illness. Stayed tuned.

-- Shari Roan

Comments

[ALec]

I take lyrica for bipolar disorder and anxiety, and it is the only (nearly) non-addictive substance which has made me feel normal. I hope they don't axe my drug because the very side effects which they warn against are what it cures me of! Lyrica is great for general anxiety (anxiety management). Just ask my psychiatrist.

[Ben Wo]

Yet another reason to use natural "herbs"

[Jfrye]

For the people taking the placebo, were they restricted from operating cars or other dangerous equipment during this test? Hmmm...

How large was the test? Was the liability for the test purely on the patients backs? Being married to a TBI survivor, I do understand the dangers of not using the Tegretol for someone who is seizure prone.

[anonymous]

I was prescribed Topamax to treat my migraines and within two weeks began suffering from crippling depression. I'd rather have migraines every day. I'm never going anywhere near this family of drugs again.

[ET]

I was given tegretol to help control muscle spasms that turned out to be diet-related. I found out that I was diabetic, and had serious suicidal thoughts at that time, for the first time in my life. I am controlling the diabetes without drugs, quite successfully, and am of course off of the tegretol. This article helps make sense of an odd psychological turn that was against my basic personality... Interesting.

[Phil]

Consider that people (like me) who take Lyrica may be having severe chronic pain, which is depressing in itself. Lyrica is the only drug yet that has dramatically help peripheral neuropathy pain (yes, I've tried herbs, acupuncture, opiates, etc). I hope this doesn't scare doctors away from these drugs.

[Vicki Rodgers]

My sister is on Tegretol and Lamictal...to control severe epilepsy. The doctors have now prescribed Clonapine and Zyprexa for her Psychotic behavior and depression. When she takes her Tegretol and Lamictal properly it controls her seizures, but with all this medication she has put on ALOT of weight...but the Tegretol outweighs..no pun intended, the weight gain.

[karen robbins]

I too take lyrica and I cannot tell you the relief. They took me off of soma after 8 years because of some scare and I could have died with pain and muscle spasms, still have the spasms but the leg pain has improved enough to go back to work. I cannot lose lyrica too because of some scare. I have a competant dr. and shrink and I would know if I felt like I wanted to hur me.
thanks again medical world.

[Kyrie]

I am lamictal and recently I am worried that I may be starting to become depressed. Nothing seems to have the spark it used to. I transfered from Depakote which I was on form May 2003 to Spetember 2007 then in 2007 went to Lamictal and now a year later I am feeling so horrible.