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BY DELTHIA RICKS
delthia.ricks@newsday.com
Doctors yesterday called for
further analysis of newly released
data suggesting patients
on anticonvulsants are likely
to commit suicide, attempt it,
or die violently and urged physicians
who’ve prescribed the
drugs to talk to their patients.
Reporting in Wednesday’s
Journal of the American Medical
Association, researchers at
Brigham and Women’s Hospital
in Boston concluded five
widely prescribed medications
for epilepsy and other conditions
are linked to potentially
deadly side effects.
The medications are identified
as gabapentin (sold as
Neurontin), lamotrigine (Lamictal),
oxcarbazepine (Trileptal)
and tiagabine (Gabitril).
Patients taking a fifth drug,
topiramate (Topamax,) were
somewhat less likely to harm
themselves, the study found.
In addition to epilepsy, the
drugs are prescribed in what the
U.S. Food and Drug Administration
calls “off-label” usage for bipolar
disorder, mania, migraine,
neuralgia and other pain syndromes.
Off-label use refers to
medications prescribed beyond
their federal license when doctors
deem the drug in a patient’s
best interest.
Dr. Alan Ettinger, an epilepsy
specialist at Neurological
Surgery P.C. in Rockville Centre,
said the study was poorly
conducted and failed to analyze
patients’ underlying
psychiatric issues.
“There are so many different
types of anticonvulsant drugs
now,” said Ettinger, co-author
of the textbook “Psychiatric Issues
in Epilepsy.” “They all
have different chemical formulas
and different mechanisms of
action. So it’s difficult to comprehend
how an entire class of
drugs with different mechanisms
of action can all cause
suicidal behaviors.”
He said it’s important patients
not abandon medications
out of fear they seed suicidal behavior.
Larger, more comprehensive
studies, he said, have
shown a strong risk of death
among epileptics who fail to
take their anticonvulsants.
Led by Dr. Elisabetta Paterno,
the study of 297,620 cases found
827 suicidal acts — 26 suicides
and 801 attempts. The study
also pinpointed 41 violent
deaths while patients were on
the medications. Researchers
did not establish how the drugs
caused self-injurious behavior.
“The study was exploratory,”
said Dr. Sean Hwang, interim
director of the Comprehensive
Epilepsy Center at Long Island
Jewish Medical Center.
“So the nature of the research
was not to delineate the underlying
cause of suicidality.”
He said depression is common
among people with epilepsy
and severe pain syndromes,
therefore “it’s important for patients
and physicians to talk
about depression and anxiety.”
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