Suicidal ideation peaks before, not after, drugs are prescribed
SAN ANTONIO (January 8, 2013) — A large new study of the suggested link between antiepileptic drugs and suicide-related behavior among veterans revealed that the risk for that behavior peaked in the month before the drugs were prescribed.
It doesn’t discount the link completely, said Mary Jo Pugh, Ph.D., an associate professor in the Department of Epidemiology in the School of Medicine at The University of Texas Health Science Center at San Antonio, but it raises important questions about the association that has been codified in an FDA warning.
“I think what it suggests is that we need to be careful about attributing everything to a drug,” said Dr. Pugh, who is also a Research Health Scientist for VA Health Services and Development Service, which funded the study.
Pugh and her fellow researchers analyzed the records of more than 90,000 older military veterans and published the findings in the Nov. 26, 2013, issue of Neurology, the medical journal of the American Academy of Neurology.
Many of the veterans who were prescribed the medicines, called AEDs, had mental health conditions such as depression or bipolar disorder, and not all had epilepsy.
“This is a cohort that may be more likely to have suicidal ideation or attempts even before receiving the drug,” Dr. Pugh said. “Probably people with depression or mental health-related diagnoses need to be screened more carefully and checked more frequently.”
The results from this group also lead to questions about how different drugs work in other age groups, she said.
“I think we need more information on specific kinds of drugs and younger patients,” Dr. Pugh said.
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