Q: 21 year old female recently started on an anti-seizure medicine is admitted to ICU after a suicide attempt. Which of the anti-epilepsy drug is more associated with the increase suicidal ideation?
A) Carbamazepine
B) Diazepam
C) Phenytoin
D) Lacosamide
E) All of the anti-seizure drugs
Answer: E
Unfortunately, less well known and very early side effect of any anti-seizure drug is an increased risk of suicidality. This effect is very high from day 7 to first six months of initiation of the treatment. This risk is shared by all antiseizure drugs and has been officially warned by the FDA.
#psychiatry
#neurology
#pharmacology
References:
1. Bell GS, Gaitatzis A, Bell CL, et al. Suicide in people with epilepsy: how great is the risk? Epilepsia 2009; 50:1933.
2. Andersohn F, Schade R, Willich SN, Garbe E. Use of antiepileptic drugs in epilepsy and the risk of self-harm or suicidal behavior. Neurology 2010; 75:335.
3. Arana A, Wentworth CE, Ayuso-Mateos JL, Arellano FM. Suicide-related events in patients treated with antiepileptic drugs. N Engl J Med 2010; 363:542.
4. Hesdorffer DC, Kanner AM. The FDA alert on suicidality and antiepileptic drugs: Fire or false alarm? Epilepsia 2009; 50:978.
5. Mula M, Kanner AM, Schmitz B, Schachter S. Antiepileptic drugs and suicidality: an expert consensus statement from the Task Force on Therapeutic Strategies of the ILAE Commission on Neuropsychobiology. Epilepsia 2013; 54:199.
No comments:
Post a Comment