Drugs Used For Epilepsy And Anxiety Linked To Increase In Suicide
A new study has linked a commonly used group of drugs known as gabapentinoids to increased suicidal behaviour, unintentional overdose, injuries, and road traffic accidents.
A new study published in the British Medical Journal, looked at over 190,000 people who collected prescriptions for gabapentinoids on the Swedish Prescribed Drug Register from 2006 to 2013.
Gabapentinoids are a class of medications used to treat pain and include the brand names Neurontin and Lyrica. They are are among the top 15 drugs prescribed globally in terms of revenue.
Neurontin (a gabapentin) is used to treat seizures, neuropathic pain, hot flashes and restless leg syndrome.
Lyrica (a pregabalin) is used for epilepsy, generalised anxiety disorder, and pain.
The researchers found that the drugs were associated with increased risk of suicidal behaviour or suicides, unintentional overdose, and car accidents.
The drugs were linked to a 26 percent increased in suicidal behaviour and risk and this relationship was seen particularly among people younger than 55-years-old.
However, because this was just an observational study, it doesn't mean that the drugs are necessarily causing these problems, only that there is some kind of relationship between their use and these adverse events.
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Dr Omid Kavahei, deputy director of the Nano Institute at the University of Sydney, told 10 daily that the study is reinforcing suspicions that researchers in the epilepsy field have long held.
"The question is whether these [suicidal behaviours] are because of the underlying condition, because of the new diagnosis, or is it actually a side effect of the antiepileptic drugs?" Kavahei said.
Rates of depression and anxiety among epilepsy patients are ten times higher than in the general population but it's been very difficult to establish whether this is caused by the epilepsy or the drugs that patients are prescribed to stop seizures.
"The findings of this study, particularly in young adults, on the link between the risk of suicide and misuse of some antiepileptic drugs as pain relief, bring us one step closer to illustrate a more clear picture of antiepileptic drugs' role," he said.
Gabapentinoids were originally approved by the Food and Drugs Administration (FDA) in the U.S. for seizures and fibromyalgia, according to a 2012 study, up to 95 percent of prescriptions for this family of drugs are for off-label prescriptions.
These include for treating migraines, mental illness, and substance dependence.
In 2008, the FDA issued a safety warning about pregabalin for its apparent role in increasing suicidal ideation, mood disturbance and depression.
Kavahei said the study should indicate that mood disorders among epilepsy patients must be better monitored.
He noted that the study highlights the importance of "early identification of mood disorders in epilepsy patients" as well as the "development of technologies" that could monitor the long term mood and psychological well-being of patients.
For conditions other than epilepsy, the efficacy of gabapentinoids are disputed in the literature -- one study published earlier this year found that there was "limited evidence" to show that gabapentinoids actually work for pain management.
Gabapentinoids are also an abused prescription medication according to the National Prescribing Service -- one of the side effects of these drugs is a strong euphoric feeling and they are often used in tandem with opioids.
In Victoria, the number of overdose deaths from using pregabalin has increased in recent years. Between 2009 and 2012, there were no deaths recorded from the drug but in 2013, that number leaped to 17 and then in 2014 it increased again to 26.