Anti seizure meds are back in the news after the The US Food and Drug Administration (FDA) reported on its analysis of almost 200 studies on various drugs. The question was – are people on antiseizure medication at more risk of suicidal thoughts?
This is an important question particularly for migraine sufferers, for a couple of reasons. First, many migraineurs are on these drugs as a treatment for migraine. They include drugs like Depakote (divalproex sodium), Neurontin (gabapentin), Lamictal (lamotrigine), Keppra (levetiracetam), and of course Topamax (topiramate).
To add to the issue, depression is comorbid with migraine, meaning that people often have both issues at the same time.
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The FDA finally concluded that there was a risk of increased suicidal thoughts for people taking these and related medications (21 medications in all). They decided that a new warning label will be required for these medications. That decision was followed in Europe, and the data is currently under review in Canada.
The decision to change warning labels has been controversial. It’s natural that there would be controversy where money is involved. Seizure medication sold to the tune of $10 billion in the United States alone in 2007.
But money isn’t the only issue. Doctors are concerned that the news is confusing patients, and they’re afraid some patients will stop taking their medication.
The risk for suicide is really very small, they say, compared to the risks of not having the medication at all.
These labels are often so arbitrary. For example, in 2007 psychiatrists convinced the FDA to scale back language on labels of antidepressants, because some patients got worried and stopped taking the medication.
What’s the answer? What you’re doing right now – we as patients need to be educated on the issues.
There’s almost no chance that taking antiseizure medication alone will cause you to commit suicide. The warning in the US will be that "about 1 in 500 patients face an increased risk of suicidal thoughts and behavior".
However, if you do suffer from depression, be aware that the drug could, in rare cases, make it worse. Discuss this with your doctor, and be sure she knows your medical history.
Do not just stop taking your medication without talking it over with your doctor.
Medications have helped many with migraine. But we need to use them knowledgeably, with caution, and with the counsel of a doctor.
For more, read Suicide risk of epilepsy drugs from the UK, and Drug regulators in United States add suicide warning to epilepsy medications
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{ 5 comments… read them below or add one }
I was on Topamax for about 3 months. It worked, once I got up to the correct dosage, for about 1 month. I stopped because it was not working anymore and I was having disturbing thoughts running through my head. The only benefit I received was a 20lb weight loss, but it was not worth it. It kind of scared me to have these thoughts running through my head.
Jeanne
It’s amazing how chemical changes can so easily impact mood and thought processes. And it’s so important to be aware of. Thanks for sharing!
I was on Topamax and didn’t have suicidal thoughts–I had homicidal thoughts. I actually had visions of killing people. My doctor never warned me about any mental or emotional issues, but I found some reports on the NIH website.
Thank God, I never acted on any of the thoughts. My wife did remove all weapons from the house and I gave up driving until all effect of the Topamax left me after stopping the drug.
I have been taking Topamax for several years and it helps for the most part, the only thing is that after about 6 mnths I have to up the dose because I get used to the dose and then it doesnt work. And I am also on 2 anti-depressants as well. I have had my migraines for 26 yrs so I guess I will take whatever I need to just not to have one.
I’ve been on most of those meds you mention. They did nothing for me except make me sicker, gained 20% of my body weight in 6 weeks, developed reoccurring “functional” ovarian cysts that ruptured whenever I ovulated (yeah, once a month), and caused suicidal ideology. I have since fired my neuro (yes, hired a more competent doc), weaned myself off of all their “preventatives”, and have turned to a natural approach for prevention.
I do, still, however, turn to the triptans for immediate relief. Do you know if it’s possible to build a tolerance to triptans? They are seeming to work less well over the long haul for me.