Anticonvulsant Drugs and Suicide or Violence Risk

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From: Lawrence A. Plumlee <_laplumlee@..._ (mailto:laplumlee@...) >

Date: Tue, May 11, 2010 at 7:14 PM

Subject: AAEM News:TEP: Anticonvulsants increase suicide risk

_laplumlee@..._ (mailto:laplumlee@...)

JAMA. 2010 Apr 14;303(14):1401-9.

Anticonvulsant medications and the risk of suicide, attempted suicide, or

violent death.

_Patorno E_

(http://www.ncbi.nlm.nih.gov/pubmed//pubmed?term= " Patorno%20E " [Author]) , _Bohn

RL_

(http://www.ncbi.nlm.nih.gov/pubmed//pubmed?term= " Bohn%20RL " [Author]) , _Wahl

PM_

(http://www.ncbi.nlm.nih.gov/pubmed//pubmed?term= " Wahl%20PM " [Author]) , _Avorn

J_

(http://www.ncbi.nlm.nih.gov/pubmed//pubmed?term= " Avorn%20J " [Author]) , _

AR_

(http://www.ncbi.nlm.nih.gov/pubmed//pubmed?term= " %20AR " [Author]) , _Liu

J_

(http://www.ncbi.nlm.nih.gov/pubmed//pubmed?term= " Liu%20J " [Author]) ,

_Schneeweiss S_

(http://www.ncbi.nlm.nih.gov/pubmed//pubmed?term= " Schneeweiss%20S " [Author]) .

Division of Pharmacoepidemiology and Pharmacoeconomics, Department of

Medicine, Brigham and Women's Hospital, 1620 Tremont St, Ste 3030, Boston, MA

02120, USA. _epatorno@..._ (mailto:epatorno@...)

Abstract

CONTEXT: In 2008, the US Food and Drug Administration mandated warning

labeling for anticonvulsant medications regarding the increased risk of

suicidal thoughts and behaviors. The decision was based on a meta-analysis not

sufficiently large to investigate individual drugs. OBJECTIVE: To evaluate the

risk of suicidal acts and combined suicidal acts or violent death

associated with individual anticonvulsants. DESIGN: A cohort study of the risk

of

suicidal acts and combined suicidal acts or violent death in patients

beginning use of anticonvulsant medications compared with patients initiating a

reference anticonvulsant drug. SETTING AND PATIENTS: Patients 15 years and

older from the HealthCore Integrated Research Database (HIRD) who began

taking an anticonvulsant between July 2001 and December 2006. MAIN OUTCOME

MEASURES: proportional hazards models and propensity score-matched analyses

were used to evaluate risk of attempted or completed suicide and combined

suicidal acts or violent death, controlling for psychiatric comorbidities

and other risk factors, among individual anticonvulsants compared with

topiramate and secondarily carbamazepine. RESULTS: The study identified 26

completed suicides, 801 attempted suicides, and 41 violent deaths in 297,620

new

episodes of treatment with an anticonvulsant (overall median follow-up, 60

days). The incidence of the composite outcomes of completed suicides,

attempted suicides, and violent deaths for anticonvulsants used in at least 100

treatment episodes ranged from 6.2 per 1000 person-years for primidone to

34.3 per 1000 person-years for oxcarbazepine. The risk of suicidal acts was

increased for gabapentin (neurontin)(hazard ratio

---

, 1.42; 95%

confidence interval [CI], 1.11-1.80), lamotrigine(lamictal) (HR, 1.84; 95% CI,

1.43-2.37), oxcarbazepine(trileptal) (HR, 2.07; 95% CI, 1.52-2.80), tiagabine

(gabatril)(HR, 2.41; 95% CI, 1.65-3.52), and valproate

(depakote,depakene)(HR, 1.65; 95% CI, 1.25-2.19), compared with

topiramate(topamax). The

analyses including violent death produced similar results. Gabapentin

(neurontin)users had increased risk in subgroups of younger and older patients,

patients with mood disorders, and patients with epilepsy or seizure when

compared

with carbamazepine(tegretol).

CONCLUSION: This exploratory analysis suggests that the use of gabapentin,

lamotrigine, oxcarbazepine, and tiagabine, compared with the use of

topiramate, may be associated with an increased risk of suicidal acts or

violent

deaths.

My Comment: This study compares these drugs to Topiramate(topomax)another

anticonvulsant drug. Whereas there are ZERO (0) suicides and deaths from B

Complex vitamins. Arnold

PMID: 20388896 [PubMed - indexed for MEDLINE]

--

Regards,

Eileen Dannemann

Director, National Coalition of Organized Women (NCOW)

_www.ProgressiveConvergence.com_ (http://www.progressiveconvergence.com/)

917 804-0786

“It requires courage to utter truth; for the higher Truth lifts her voice,

the louder will error scream, until its inarticulate sound is forever

silenced in oblivionâ€â€¦ Baker Eddy, Christian Science

" Just Remember,

when the weeding process takes place,

you are the flowers. "

- Charlie Lutes

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