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Bipolar Disorder Epilepsy Drugs: Less Suicide?

Studies contradict the FDA and find that treatment does not pose a risk of bipolar suicide

Daniel J. Denoon
WebMD Health News

Review by Louise Chang, MD

December 8, 2009-In January last year, the FDA warned of an increased risk of suicide in patients treated with epilepsy drugs. However, a new study found that patients with bipolar disorder had fewer suicide attempts.

The panel voted against putting a strong “black box” warning on the drug label, even though an external panel of experts confirmed the link between suicide and the treatment of bipolar disorder with anticonvulsants. ..

Now, an analysis of new data by researchers at the University of Chicago, Dr. Robert D. Gibbons, suggests that antiepileptic drugs actually reduce the risk of suicide in patients with bipolar disorder.

“Current analysis does not provide evidence that antiepileptic drugs increase the risk of attempted suicide in patients with bipolar disorder,” they conclude. “Most antiepileptic drugs and lithium are associated with a reduced suicide attempt rate compared to pretreatment levels in patients who were ultimately prescribed these drugs.”

The Gibbons analysis contains 11 drugs.

There is no conclusive evidence that these drugs actually help people with bipolar disorder. However, doctors who prescribe drugs often find it very useful for patients with bipolar disorder who fail other treatments.

Bipolar disorder itself significantly increases the risk of suicide. According to a 2006 study, 40 out of 1000 people with bipolar disorder commit suicide each year.

Gibbons and colleagues, who questioned the link between antidepressants and suicide in a previous study, analyzed data from approximately 48,000 patients with bipolar disorder in a large healthcare billing database.

They found that patients who received antiepileptic drugs had the same number of suicide attempts as those who did not receive such drugs and those who received lithium, the first-line treatment for bipolar disorder. discovered.

Interestingly, patients treated with antiepileptic drugs have far more pretreatment attempts to commit suicide than those who have not been treated with antiepileptic drugs, and these drugs are given to patients with more severe bipolar disorder. It suggests that there are many cases.

Despite a high pretreatment suicide attempt rate, those treated with antiepileptic drugs had a low post-treatment suicide attempt rate.

Gibbons reports that he has or is currently an expert witness to the US Department of Justice, Wyeth, and Pfizer Pharmaceuticals. Gibbons reports that Pfizer’s case is associated with one of the drugs studied in the study, Neurontin.

The study was published in the December issue of Archive of general psychiatry.

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References

Source: Gibbons, RD Archive of general psychiatry, Vol 66: pp1354-1360.

WebMD Health News: “FDA Panel: No Warnings About Epilepsy Drugs”

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Bipolar Disorder Epilepsy Drugs: Less Suicide?

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