Epilepsy and mood

Abstract

In their article, “Use of antiepileptic drugs in epilepsy and the risk of self-harm or suicidal behavior,” Dr. Andersohn and his coauthors1 tried to better understand a very difficult problem. For years, it has been known that there is a higher rate of suicide in people with epilepsy. People with epilepsy are also more likely to have depression, which can lead to suicide. In addition, some of the medications that are used for seizures (also called antiepileptic drugs or AEDs) may cause problems with mood. Because all of these problems overlap, it can be difficult to sort out how they are related. In early 2008, the United States Food and Drug Administration (FDA) issued a safety alert concerning all AEDs. The alert was based on 199 studies. In these studies, an antiepileptic medication was compared to placebo. A placebo is a fake medication to see if the actual medication works. When grouped together, the analysis showed that there was an increased risk of suicidal thoughts and behavior in people who were taking an AED. The FDA analysis grouped all seizure medications together. It was not possible, based on the information that they had, to decide if there were specific medications that were more likely to cause mood problems. Dr. Andersohn and his coauthors decided to answer this question, if possible. What they wanted to know was simple: Are there certain medications that cause this more often than others? Dr. Andersohn and his coauthors wanted to gather as much information as possible on these medications. To do this, they used a database of medical information. The database has been in place in the United Kingdom for several years. It is called the General Practice Research Database. The information is gathered in an anonymous way to protect patients. The information is …