Antiepileptic Drugs and Suicide: A Systematic Review of Adverse Effects

Ferrer, Pili; Ballarín, Elena; Sabaté, Mònica; Vidal, Xavier; Rottenkolber, Marietta; Amelio, Justyna; Hasford, Joerg; Schmiedl, Sven; Ibáñez, Luisa

doi:10.1159/000356807

Cited by 45 publications

(27 citation statements)

References 52 publications

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“…Although the mechanism of action is not known, AEDs as a drug class may be associated with increased risk of suicidal behaviors and ideation (8). Specifically, memory impairment, cognitive disorder, increased/decreased weight, rash, and suicide-related TEAEs were each reported by <5% of patients.…”

Section: Discussionmentioning

confidence: 99%

Long-term adjunctive lacosamide treatment in patients with partial-onset seizures

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Long-term adjunctive lacosamide treatment in patients with partial-onset seizures

et al. 2015

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“…However, the supplement also includes descriptive and outcome validation studies and two assessments of the use of instrumental variables as a method for control of confounding. Several manuscripts from the PROTECT project were published prior to the development of this supplement …”

Section: Protect's Organizational Structure and Goalsmentioning

confidence: 99%

The IMI PROTECT project: purpose, organizational structure, and procedures

Reynolds

Kurz²,

Groot

et al. 2016

Pharmacoepidemiology and Drug

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The Pharmacoepidemiological Research on Outcomes of Therapeutics by a European ConsorTium (PROTECT) initiative was a collaborative European project that sought to address limitations of current methods in the field of pharmacoepidemiology and pharmacovigilance. Initiated in 2009 and ending in 2015, PROTECT was part of the Innovative Medicines Initiative, a joint undertaking by the European Union and pharmaceutical industry. Thirty-five partners including academics, regulators, small and medium enterprises, and European Federation of Pharmaceuticals Industries and Associations companies contributed to PROTECT. Two work packages within PROTECT implemented research examining the extent to which differences in the study design, methodology, and choice of data source can contribute to producing discrepant results from observational studies on drug safety. To evaluate the effect of these differences, the project applied different designs and analytic methodology for six drug-adverse event pairs across several electronic healthcare databases and registries. This papers introduces the organizational structure and procedures of PROTECT, including how drug-adverse event and data sources were selected, study design and analyses documents were developed, and results managed centrally.

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“…Of these, lamotrigine was found to increase the risk for suicidal behaviour and this is an oxymoron since lamotrigine is effi cacious in the treatment of bipolar depression. A number of methodological issues and problems are in place again and further research is necessary (Ferrer et al 2014 ;Fountoulakis et al 2012a ).…”

Section: Suicidalitymentioning

confidence: 99%

Special Issues

Fountoulakis¹

2014

Bipolar Disorder

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It is well known that concerning the prevalence of unipolar depression, females have almost double rates in comparison to males (Lloyd and Miller 1997 ;Blazer et al. 1994 ). However, this does not hold true concerning BD, for which similar rates between males and females are reported. There are some data suggesting that males might be over-represented in those diagnosed with a BD-I and females overrepresented in those diagnosed with a BD-II disorder (Parker et al. 2014 ).Some authors suggest that females with less social support and experiencing social stressors might be at the greatest risk to develop depression, but this concerns unipolar and not bipolar cases. It has been documented that women are more likely to experience stressful and even threatening life events and are at a higher risk of early sexual abuse and current spousal abuse (Roesler and McKenzie 1994 ;Finkelhor et al. 1990 ). Women also might use oral contraceptive and often experience mood disorders temporally related to their gender identity (e.g. premenstrualor postpartum-onset mood disorders) which might have an impact on the course of BD (Meinhard et al. 2014 ). A number of adverse experiences related to sexual life and determined by gender seem to happen in the lives of bipolar women. In comparison to healthy women, bipolar women might be more likely to have been forced by their partners to have sex, raped or suffering from sexually transmitted diseases. The use of contraceptives is usually sporadic and their rates of pregnancy and abortion are high (Ozcan et al. 2014 ).Also, in almost all societies, unequal roles for women are in place, and additionally there is a gender difference in copying styles; men might react to emotional distress by trying not to think about it, while women are more likely to ruminate over their problems (Nolen-Hoeksema and Girgus 1994 ;Nolen-Hoeksema et al. 1999, 2007. In this frame, women are more likely to report depressive symptoms due to marital problems than men (Joiner et al. 1992 ;Hammen and Peters 1978 ) and are more likely to be diagnosed with depression because they seek professional help more often for their depressive symptoms and maybe because they are more 660 sensitive to negative relationships (Phillips and Segal 1969 ). Concerning the neurocognitive function, the data are inconsistent (Bucker et al. 2014 ;Suwalska and Lojko 2014 ).Overall there does not seem to be any signifi cant gender difference concerning the risk of recurrence, thus suggesting that gender is among the risk factors for initiating depressive symptoms in unipolar depression but not among those determining the course and outcome either in unipolar or in bipolar cases (Nazroo et al. 1997 ;Philibert et al. 1997 ).There are a number of comorbid conditions which seem to be more frequent in bipolar women, including abdominal obesity. This happens possibly because of a higher frequency of predominant depressive polarity in women and more seasonal variations in mood disturbance and reproductive life events and related treatments (Baskara...

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Antiepileptic Drugs and Suicide: A Systematic Review of Adverse Effects

Cited by 45 publications

References 52 publications

Long-term adjunctive lacosamide treatment in patients with partial-onset seizures

Long-term adjunctive lacosamide treatment in patients with partial-onset seizures

The IMI PROTECT project: purpose, organizational structure, and procedures

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