Epilepsy, antiepileptic drugs and suicidality

Bagary, Manny

doi:10.1097/wco.0b013e328344533e

Cited by 41 publications

(23 citation statements)

References 48 publications

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“…Antiepileptic drugs have also been suggested to increase the risk of suicide, although the evidence is inconclusive. 28 Depression and suicidal ideation have been shown to be more common in patients with inflammatory bowel disease than the general population in a Canadian study. 29 However, we found that the incidence of self-harm was lower than average in patients with ulcerative colitis and neither high nor low in Crohn's disease overall.…”

Section: Mechanisms Of Associationmentioning

confidence: 96%

Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage

et al. 2014

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Background: Psychiatric illnesses are known risk factors for self-harm but associations between self-harm and physical illnesses are less well established. We aimed to stratify selected chronic physical and psychiatric illnesses according to their relative risk of self-harm. Design: Retrospective cohort studies using a linked dataset of Hospital Episode Statistics (HES) for 1999-2011. Participants: Individuals with selected psychiatric or physical conditions were compared with a reference cohort constructed from patients admitted for a variety of other conditions and procedures. Setting: All admissions and day cases in National Health Service (NHS) hospitals in England. Main outcome measures: Hospital episodes of self-harm. Rate ratios (RRs) were derived by comparing admission for self-harm between cohorts. Results: The psychiatric illnesses studied (depression, bipolar disorder, alcohol abuse, anxiety disorders, eating disorders, schizophrenia and substance abuse) all had very high RRs (> 5) for self-harm. Of the physical illnesses studied, an increased risk of self-harm was associated with epilepsy (RR ¼ 2.9, 95% confidence interval [CI] 2.8-2.9), asthma (1.8, 1.8-1.9), migraine (1.8, 1.7-1.8), psoriasis (1.6, 1.5-1.7), diabetes mellitus (1.6, 1.5-1.6), eczema (1.4, 1.3-1.5) and inflammatory polyarthropathies (1.4, 1.3-1.4). RRs were significantly low for cancers (0.95, 0.93-0.97), congenital heart disease (0.9, 0.8-0.9), ulcerative colitis (0.8, 0.7-0.8), sickle cell anaemia (0.7, 0.6-0.8) and Down's syndrome (0.1, 0.1-0.2). Conclusions: Psychiatric illnesses carry a greatly increased risk of self-harm as well as of suicide. Many chronic physical illnesses are also associated with an increased risk of both self-harm and suicide. Identifying those at risk will allow provision of appropriate monitoring and support.

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Section: Mechanisms Of Associationmentioning

confidence: 96%

Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage

et al. 2014

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“…The effectiveness, safety, and tolerability of other pharmacologic and non-pharmacologic treatments that have not been associated with increased suicidality should be taken into account in this benefit-risk assessment. Although the benefits of AED treatment in epilepsy generally outweigh the risk of treatment-emergent suicidality [4], such an overall evaluation has unfortunately not been conducted for patients with chronic pain.…”

Section: Discussionmentioning

confidence: 99%

Suicidality associated with antiepileptic drugs: Implications for the treatment of neuropathic pain and fibromyalgia

Pereira

Gitlin

Gross

et al. 2013

Pain

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“…For instance, use of: antiepileptics 30) ; benzodiazepines 31) ; antidepressants 32) ; barbiturates 33) ; analgesics 34) ; and antimalarials 35) for self-harm have been reported. Among these, barbiturates have been an extremely common means of self-poisoning throughout the developing world's cities.…”

Section: Discussionmentioning

confidence: 99%

Prospective Assessment of Patterns, Severity and Clinical Outcome of Indian Poisoning Incidents

et al. 2012

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The objective of this study was to assess the patterns, severity and clinical outcome of poisoning incidents. A prospective assessment was conducted over a period of 1 year in tertiary-care teaching hospitals. Glasgow coma scale (GCS), poisoning severity score (PSS), and snake bite severity score (SSS) were used to predict the severity of poisoning, and then compared to the clinical outcome. The study involved 212 patients with a mean age of 26.7 12.7 years. Pesticides were found to be the most common poisoning agents. The incidents of intentional poisoning (n 178) were higher than accidental (n 34) poisoning. Poisoning incidents were higher in male population (n 132) compared to female population (n 80). The poisoning incidents were predominantly higher among literates (n 155). The poisoning incidents were higher in rural areas (n 129), followed by urban (n 53) and semi-urban (n 30) areas. The poisoning incidents were highest in the middle class population (n 108), followed by poor class (n 101) and rich class (n 3) population. A majority of patients whose severity of illness was predicted to be mild to moderate recovered from the poisoning. In contrast, patients whose illness was predicted to be severe were either discharged with severe morbidity or deceased. There was a moderate correlation between GCS and PSS scoring systems (r 0.51, p<0.001).

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Epilepsy, antiepileptic drugs and suicidality

Cited by 41 publications

References 48 publications

Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage

Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage

Suicidality associated with antiepileptic drugs: Implications for the treatment of neuropathic pain and fibromyalgia

Prospective Assessment of Patterns, Severity and Clinical Outcome of Indian Poisoning Incidents

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