Since 2008, the U.S. Food and Drug Administration has required that all epilepsy drugs bear a warning label about an increased risk of suicidal behaviors, but German doctors report that only certain medications may increase the risk of self-harm.

However, some epilepsy researchers are skeptical of the findings and say the paper raises more questions than it answers.
The study of more than 44,000 epilepsy patients in the United Kingdom revealed that those who took relatively new antiepileptic drugs with a higher risk of causing depression, such as levetiracetam (Keppra), topiramate (Topamax) and vigabatrin (Sabril), were three times more likely to harm themselves or attempt suicide than those who weren't taking any epilepsy medications.
The researchers found that patients who took conventional epilepsy medications, such as divalproex (Depakote, Depakote ER, Depakene) or phenytoin (Dilantin), or newer drugs with a low risk of depression, such as gabapentin (Neurontin) or lamotrigine (Lamictal), faced no increased risk of self-harm of suicidal behavior.
“These potential adverse effects should be considered in the selection of antiepileptics and during monitoring of the effects of these medications in epilepsy patients,” said study author Dr. Frank Andersohn, of the Medical Center in Berlin.
“Patients with epilepsy who are currently taking an antiepileptic drug that might increase the risk of depression and/or suicidal behavior should, however, not abruptly stop or change their medication but should discuss this issue with their physician.”
Andersohn and his colleagues examined data on 44,300 patients in the United Kingdom General Practice Research Database who had epilepsy and had at least one prescription for an epilepsy drug from 1989 through 2005. Participants were followed for an average of five-and-a-half years.
During that time, 453 patients had harmed themselves or attempted suicide, and 78 people died at the time or within four weeks of the initial attempt. The 453 patients were compared with 8,962 others who had not harmed themselves or attempted suicide. Six of the 453 people, or 1.3 percent, who harmed themselves or attempted suicide were taking the newer drugs with the higher risk of depression, compared with 45 of the 8,962 people, or 0.5 percent, of those who didn't harm themselves.
The findings were published in the July 27 issue of Neurology.
(Source: HealthDay News)