Assessing the Potential Link between Antiepileptic Drug Use and Risk of Suicide Attempt

To assess the possible link between antiepileptic drug use and risk of suicide attempt, researchers in France examined cases of 506 adult patients who, in the month prior to study initiation, had one suicide attempt that required hospitalization for at least 12 hours, but had no prior episodes in the previous year.

Taking into account comorbid psychiatric and neurological conditions, they compared them to a group of age- and sex-matched 2,829 controls who had no history of suicide attempt in the same period.

For all the case group, the researchers collected data on antiepileptic drug use, lifestyle and socioeconomic factors, and medical history. The same data was collected for the controls by their general practitioners. Data on drug exposure was “self-reported by participants through standardized patient telephone interviews.”

Using logistic conditional regression and adjusted analyses after stratifying for depression and neurological status, the researchers mapped out the association between antiepileptic drug use and risk of suicide attempt.

They found “a crude association” between antiepileptic drug use in the previous year and risk of suicide attempt (OR, 3.1; 95% CI, 2.1—4.5). Antiepileptic drug use was associated with risk of suicide attempt in patients with current and/or past depression, “but this was no longer the case when clonazepam was excluded from the group of antiepileptic drugs (OR, 0.9; 95% CI, 0.5–1.7).”

The researchers reported no significant association between antiepileptic drug use and risk of suicide attempt in patients with epilepsy, migraine or chronic neuropathic pain (OR, 1.3; 95% CI, 0.6—2.8).

Based on their analysis of the data, the researchers concluded that the association between antiepileptic drug use and risk of suicide attempt “is explained by underlying psychiatric or neurological conditions.”