JAMA Neurology: Does new anti-epileptic drugs increase the risk of suicide in patients?

In 2008, the US Food and Drug Administration Bureau ( the FDA ) issued an alert, said the anti- epileptic drugs (ASMs) will increase the suicide rate, which is based on 199 randomized placebo-controlled clinical trial meta-analysis, including 11 kinds of ASMs: Card Mazepine, febramide, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, tiagabine, topiramate, sodium valproate, and zonisamide

Since 2008, the pivotal ASM epilepsy trial has prospectively assessed suicide, and since 2011, it has included a valid Columbia Suicide Severity Scale (C-SSRS)

In this way, Pavel Klein of New York University and others reviewed all randomized, placebo-controlled phase 2 and phase 3 studies of new ASMs to compare the suicide rate of patients treated with ASMs and placebo to determine whether these drugs Related to an increased risk of suicide

Suicidalism was evaluated in 17 randomized clinical trials of these drugs, involving 5996 patients, of which 4000 patients were treated with ASMs and 1996 patients were treated with placebo

There is no evidence of the overall risk of suicidal ideation (total hazard ratio of drug to placebo, 0.

Among the 4000 patients treated with ASMs, 12 had suicidal ideation (0.

The important significance of this meta-analysis lies in the discovery: There is currently no evidence that the five ASMs evaluated in this study increase the suicidality of patients with epilepsy and are worthy of issuing a suicide grade warning