Chapter 14 - Antiepileptic drugs and suicide

Summary

The FDA alert has drawn attention to the possible effects of antiepileptic drugs (AEDs) on suicidal behaviors which have stimulated several epidemiological investigations, and a search for possible mechanisms. This chapter reviews these investigations and mechanisms. There is much use of AEDs in psychiatric practice to stabilize mood disorders, and it is of interest that none of these GABAergic drugs has found use or been approved by regulatory authorities for the treatment of mood disorders in psychiatry. Associations between antiepileptic drugs and attempted suicide have been noted associated with the ingestion of barbiturates. Depression is only one of the psychiatric presentations associated with suicidal behaviors, but links have been shown between depression, attempted suicide, and completed suicide. A second important link of prescription of AEDs is with personality changes. One consequence of the FDA alert is that neurologists who treat epilepsy need to pay attention to psychiatric comorbidities.