Anti-Epileptic Drugs Found Safe to Treat Bipolar Disorder

Research suggests that, contrary to FDA reports, they do not raise risk of suicidality

WEDNESDAY, Dec. 9 (HealthDay News) -- The risk of suicidality among bipolar disorder patients treated with anti-epileptic drugs does not increase relative to those taking lithium or no drugs, according to a study published in the December issue of the Archives of General Psychiatry.

Robert D. Gibbons, Ph.D., of the University of Illinois in Chicago, and colleagues analyzed data from a medical claims database on 47,918 bipolar disorder patients to ascertain suicide attempt rates among those taking any of 11 anti-epileptic drugs that were included in a U.S. Food and Drug Administration alert on increased risk of suicide, as well as rates for those taking lithium, or neither type of medication.

There were 13 suicide attempts per 1,000 person-years for patients taking an anti-epileptic drug and for patients not treated with an anti-epileptic drug or lithium, but the rate for those treated with anti-epileptic medications dropped from 72 per 1,000 person-years prior to treatment, the researchers found.

"Drawing causal inference from observational data is complicated in general, but even more complicated for the study of suicide," the authors write. "In summary, the present analysis provides no evidence that anti-epileptic drugs increase risk of suicide attempts in patients with bipolar disorder. Most anti-epileptic drugs and lithium are associated with reduction in suicide attempt rates relative to pretreatment levels in patients who are ultimately prescribed these drugs."

The lead author reported serving as an expert witness for Pfizer Pharmaceuticals, which manufactures gabapentin, one of the drugs used in the study, but Pfizer was not involved in the research data.

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