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.
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 U.S. orders suicidal action warning on epilepsy drugs from the UK, and FDA adds suicide warning to epilepsy drugs