PSA - warning on suicidal thoughts from epilepsy drugs

[drcuriosity]

wolfwitch came across this article entitled "FDA Orders a Warning for Antiepileptic Drugs About Increased Risk of Suicidal Thoughts and Behaviors".

Looking through the list I can see at least a couple of drugs that I know friends of mine are prescribed (Klonopin and Topamax, for starters), so if you're on such medications it might pay to check it out - especially if you're already prone to mood-related issues.

Comments

[spryghte.livejournal.com]

I'm on Klonopin for anxiety disorder and I'm bi-polar. But I don't take the Klonopin on a daily basis. I take the melt on your tongue tabs only when I have a panic attack.

[rane500.livejournal.com]

These studies are always so iffy, although I don't dispute the possibility. The problem - as noted by my own psychiatrist - is that you're already dealing with a pool of people experiencing some form of brain disorder. Chances are you're probably upset about the condition in the first place, so it's very hard to say where causation begins. Still, it is nice to see them taking the safe path and issuing the warning. Sometimes psychiatric medications aren't labeled well enough.

The truly sad part is the irony; I take Lamictal (Lamotrigine) for being bi-polar, and it nicely nipped those suicidal thoughts almost completely - as it was supposed to do. It's always a cruel twist when an anxiety medication causes greater anxiety or something like an anti-seizure causes suicidal depression.

[drcuriosity]

The fact that people are already upset about their conditions is why such studies use double-blind testing where you could just as easily be getting a placebo as a potential treatment.

That said, pretty much every medication carries some degree of inherent risk, with human physiology being as complex and varied as it is. If I was taking something that meant there was even a small chance I'd start having suicidal feelings, I'd far rather be aware of that so that if it happened, I'd have a better chance of knowing it was the drug rather than my life just sucking that badly.

[happyevilslosh.livejournal.com]

Extra 1 in 500? Doesn't sound overly statstically significant (although I'll point out I don't think the warning is unwarrented). Seems like alarmism if you ask me.

[drcuriosity]

When it comes to side-effects from relatively commonly-prescribed medications, one in 500 is quite a few more potentially suicidal people than there may have been previously. I know enough people who are on or could be put on one or more of those drugs that I'd rather people were aware of the potential risks, all the same - and that's just those who've mentioned their medications around me.

As to the statistical significance, they're looking at results over a span of 199 drug trials. Though I don't know how many people were involved in each trial, that's still around 18 trials per drug if we assume a uniform distribution. We're talking FDA trials here, so I think it's a relatively safe assumption that each of those trials would be conducted with enough people to have a good chance of getting statistically significant results.

[happyevilslosh.livejournal.com]

Nonetheless some error bounds would have been nice. :) I'm sure we all remember the results of the first second hand smoke study...

[drcuriosity]

Actually, no. It's unfamiliar to me.

[happyevilslosh.livejournal.com]

Oh OK. Well until like 2 years ago there was one essentially one paper that the harm of second hand smoke was based one (I can try hunt down the name if you want). The problem was in terms of the number of people involved the chances of dying without being exposed to second hand smoke was 1 in 100,000, whereas if you were exposed it was 1 in 80,000. Now that wasn't a great problem in the sense that I believe most early comments on the paper noted that the difference wasn't statistically significant - it should at best be a ground for more extensive studies - however people (most notably the media) were running around claiming to governments et al. that your chances of dying increased 25% when exposed to second hand smoke.

[mugginsm.livejournal.com]

I've been on various drugs in the past that had that effect. It's quite common for antidepressants.

Knowing it's just a side effect makes it a whole lot easier to handle.

The mind is an incredible thing, and I still find it interesting how personality is affected by chemicals.

- MugginsM