Current evidence does not support increased suicidality for certain newer antiseizure medications; class warning may not be merited
THURSDAY, Aug. 12, 2021 (HealthDay News) — Some newer antiseizure medications (ASMs) do not appear to increase suicidality in epilepsy, according to a review published online Aug. 2 in JAMA Neurology.
Pavel Klein, M.B.B.Chir., from Mid-Atlantic Epilepsy and Sleep Center in Bethesda, Maryland, and colleagues conducted a literature review to identify placebo-controlled phase 2 and 3 studies of 10 ASMs approved since 2008. The researchers performed a meta-analysis of data from studies for five ASMs that prospectively evaluated the risk for suicidality of these drugs compared to placebo.
Based on 17 identified studies (5,996 patients), the researchers observed no evidence of an increased risk for suicidal ideation (ASMs versus placebo overall risk ratio, 0.75; 95 percent confidence interval, 0.35 to 1.60) or attempt (risk ratio, 0.75; 95 percent confidence interval, 0.30 to 1.87) overall. Results were similar for each individual drug (eslicarbazepine, perampanel, brivaracetam, cannabidiol, and cenobamate). Twelve of 4,000 patients treated with ASMs experienced suicidal ideation (0.30 percent) versus seven of 1,996 patients treated with placebo (0.35 percent; P = 0.74), while three patients treated with ASMs and no patients treated with placebo attempted suicide (P = 0.22). There were no completed suicides in either group.
“There is no current evidence that the five ASMs evaluated in this study increase suicidality in epilepsy and merit a suicidality class warning,” the authors write.
Several authors disclosed ties to the pharmaceutical industry.
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