Experts have just met in July to review evidence that anti-seizure medications may put patients at a higher risk of suicide and suicidal ideation (persistent thoughts of suicide). The hope is that they will concur with the belief that these medications should carry the FDA’s highest ‘Black Box’ warning label.
If one of your medications has such a label on it, it’s important that you read it and ask your doctor to explain any parts you don’t understand.
The impetus behind this meeting was the FDA’s own statistical review of studies into 11 different medications.
The drugs which have been causing concern are listed below.
- Carbamazepine
- Felbamate
- Gabapentin
- Iamotrigine
- Levetiracetam
- Oxcarbazepine
- Pregabalin
- Tiagabine
- Topiramate
- Valproate
- Zonisamide
The FDA concluded that patients prescribed these medications were at nearly double the risk of suicide and suicidal ideation compared to placebo treated patients. Given that many epilepsy patients would already be at a greater risk of suicide and suicidal ideation due to factors such as stress and social isolation this is a huge risk.
How this will affect prescribing guidelines has yet to be seen. Prescribing guidelines are the rules given to doctors about what drugs they can and can’t use, who they can give medications to and what warnings they need to issue.
In the mean time here are some things to look out for and what to do if you are concerned. The first port of call should always be your doctor but don’t be afraid to ask for a second opinion.
Sudden or unexplained changes in behaviour particularly withdrawing from social contact and people isolating themselves in their rooms can be a good indication that something’s wrong.
Similarly loss of appetite, insomnia or suddenly seeming very lethargic despite sleeping excessively; Loss of appetite and becoming very apathetic. These can all be symptoms of depression.
Another thing to look out for {although this can have other explanations in teenagers} is people appearing to become very body conscious to the extent where they are hiding themselves. This can often be a sign that they are self injuring.
The best defence is to encourage open communication with your children {this is very very important with boys.} Feelings of suicidality become most dangerous when the person is trying to cope with them in isolation.
Again discussing concerns with your doctor and having a doctor who will listen to your child and take them seriously is fundamental.
Lastly don’t panic! Drug reactions are rare but when they do happen they generally happen shortly after starting a new drug regime at which point doctors will be looking for side effects and with a measured withdrawal of medication they can be reversed.
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