Suicide Risk From 11 Epilepsy Drugs

[stilldancing_98]

Anything positive you can swallow do it. It will save you if even for a minute. A song, a hug, some good food or drink. A walk finally in the sun is very good for depression. Loud music while you are cleaning your house or apartment. Find a reason to be outside. You are all worth it. Say Im proud of my self and I love myself . Give yourself a hug, do the breathing excercises that Bernard talks about and Don't Worry we got your back. I know this was corny.

[RobinN]

Nothing is ever corny here...
All good suggestions.

[RobinN]

Pfizer defends safety of Lyrica ahead of FDA meeting on suicide risks of seizure drugs

WASHINGTON (AP) -- Pfizer Inc., the world's largest drug maker, is trying to persuade government regulators not to add stern warnings about suicide risks to its best-selling epilepsy drug.

The Food and Drug Administration said Monday that all drugs used to treat seizures should be required to carry "black box" warning labels about increased suicidal thoughts and behavior. The agency will ask a panel of outside experts to weigh-in on that recommendation at a meeting Thursday.

FDA analysis of nearly 200 studies showed that patients taking anti-seizure drugs were twice as likely to have suicidal tendencies as those not taking the drugs.

The FDA based its analysis on 11 widely used anti-seizure medicines but has stated it wants to add warnings to all drugs in the class. Panelists will be asked to comment on that recommendation.

Seizure drugs were the fifth best-selling class of drugs in the U.S. last year, according to health care research firm IMS Health.

GlaxoSmithKline, which makes the drug Lamictal, has said the FDA's analysis of suicidal risks is similar to its own conclusions and should be added to drugs' labeling.

Lamictal was the best-selling epilepsy treatment in the U.S. last year, with sales of $2.1 billion, according to IMS Health.

Pfizer, however, disagrees with the FDA analysis. The New York-based company markets the nation's third best-selling epilepsy drug Lyrica with sales of $1.1 billion.

In documents posted online Wednesday by the FDA, Pfizer said its own analysis shows Lyrica is not "associated with an increased risk of suicidal behavior or thinking."

The company argues that Lyrica works differently than other anti-seizure medications and should not be subject to the generalized warning favored by the FDA.

"Pfizer is confident in the safety and efficacy profile of these important medicines as reflected in our current labeling," the company said in a statement earlier this week.

The FDA panel of neurologists, statisticians and psychiatrists will hear from government scientists as well as researchers from GlaxoSmithKline and Pfizer. The agency is not required to follow the panel's advice, though it often does.

Doctors who prescribe the medications have been urging the FDA to take a measured approach to any new warnings, arguing they could cause more harm than good if patients stop taking the drugs completely.

Representatives from the American Academy of Neurology are expected to stress Thursday that epilepsy patients are already prone to depression and suicidal behavior, making it difficult to gauge the negative impact of the drugs.

http://biz.yahoo.com/ap/080709/seizu....v=1&printer=1

[Belinda5000]

The worst drugs for me where Neurontin,Phenobarbbut there have been plenty others that have made it so bad I attempted suicide 4 times.
The docs didn't try understand it when I was a teenager growing up in the 70's it was blamed entirely on me.
Belinda

[Meetz1064]

Although, it wasn't when I was a teenager. It was when I was a young mother. I've been on or am on at least 4 of those drugs.

HOW DEPRESSING.

[Loudmouth]

depressive thoughts now than EVER before. I am keeping on trying to pull myself up by my shoelaces for the kids cos they need me. I will NEVER do to them what my dad did to me. My dad had bi-polar disorder and when I was 10 he killed himself, so I know first-hand what it's like to be the child left behind afterwards. BUT I wont say it's easy to stay up-beat when some days it seems like even your own doctors are fighting against you. I am taking a combination of 1200mg/day gabapentin (neurontin) and 75mg/day topamax...Some days all you want to do by the end of them is sit in the corner and cry and scream......... I HATE EPILEPSY!!!!!!!!

[Cint]

Epilepsy Drugs Can Cause Suicidal Tendencies, FDA Panel Finds

07.09.08, 8:00 PM ET

THURSDAY, July 10 (HealthDay News) -- Anti-seizure drugs can cause increased suicidal tendencies in patients, a U.S. health advisory panel concluded Thursday.
The 20-member panel of experts voted unanimously to back the findings on 11 antiepileptic drugs studied by the U.S. Food and Drug Administration, the Associated Press reported.

In late January, the FDA announced an agency review of 199 studies comparing the drugs, which are used by millions, to placebos. That review found that patients taking the drugs had about twice the risk of suicidal behavior compared with patients taking a placebo. In fact, of the almost 44,000 patients in the studies, four people taking antiepileptic drugs committed suicide while none of the patients receiving a placebo did.

"We have been looking at these drugs since 2005," FDA spokeswoman Sandy Walsh said at the time. "We have just come to the conclusion that it's time to alert health-care providers."

The drugs under review were: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR), Felbamate (marketed as Felbatol), Gabapentin (marketed as Neurontin), Lamotrigine (marketed as Lamictal), Levetiracetam (marketed as Keppra), Oxcarbazepine (marketed as Trileptal), Pregabalin (marketed as Lyrica), Tiagabine (marketed as Gabitril), Topiramate (marketed as Topamax), Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon) and Zonisamide (marketed as Zonegran). Some of these drugs are also available as generics.

According to the FDA, antiepileptic drugs are used to treat epilepsy, bipolar disorder, migraine headaches and other conditions.

As of now, the FDA is advising patients not to make any changes in their medication without talking to their doctor, Walsh said in January. "Caregivers should pay close attention to changes in mood, behavior and actions," she said. "They should be aware of the development of these symptoms."

One expert is on record as supporting the FDA move.

"This is not new, it's something that has been known for a long time," Epilepsy Foundation Vice President John Schneider said earlier this year.

Schneider noted that some people with epilepsy may be clinically depressed, so it's hard to tell whether it's the medication or the condition that is causing the suicidal behavior.

"Patients need to know their medications," Schneider said. "The goal should be no seizures and no side effects."

But another expert found the association between antiepileptic medicines and suicide surprising.

"We do know that the incidence of comorbid affective [emotional] disorders and risk of suicide is higher in patients with epilepsy compared with the general population, and therefore it is not surprising to see higher incidence of suicide in the FDA report," said Dr. Gholam Motamedi, director of the Epilepsy Service at Georgetown University Hospital, in Washington, D.C.

However, the data showing a raised risk of suicide with medication use is surprising, Motamedi said.

"It's also surprising to attribute suicide to the antiepileptic drugs, per se, because a good number of these drugs are used in psychiatry for their positive effects on mood and depression," Motamedi said. "Nevertheless, this emphasizes the importance of screening for signs and symptoms of depression and suicidal tendencies in the epilepsy clinics."

[Cint]

US advisers reject strong epilepsy drug warning

Reuters, Thursday July 10 2008

By Susan Heavey


BELTSVILLE, Md., July 10 (Reuters) - Anti-seizure drugs used to treat epilepsy carry an increased risk of suicidal thoughts and behavior but not enough to warrant a black box warning, a U.S. advisory panel concluded on Thursday.

Members of the Food and Drug Administration's panel of outside experts were concerned a strong warning could scare epilepsy patients from being treated with effective drugs.

"I am very concerned ... about the risk of unintended consequences of influencing practice and discouraging patients," said panel member Daniel Pine, of the National Institutes of Health.

The advisers said the suicide risk applied to all epilepsy medications, despite arguments by Pfizer Inc that its two products were better. But there was not enough data to call for the strong boxed caution, the panel decided by a 14-4 vote. Three members abstained.

Epilepsy drugs include Pfizer's Lyrica and Neurontin, GlaxoSmithKline Plc's Lamictal, Johnson & Johnson's Topamax and UCB Inc's Keppra, among others.
The FDA had proposed adding the boxed warning but sought the advisory panel's advice before making a final decision.

Some epilepsy drugs already caution about possible suicide.
Similar suicide warnings have been added in recent years to drugs for depression. Some panel members expressed concerns about the effect those cautions had on patients, noting that anti-depressant prescriptions have declined.
"What we saw ... was a real scare factor," said Gail Griffith, a consumer representative on the panel.

FDA officials said it was too early to see what impact the depression drug warnings had on related suicides but said boxed warnings are meant draw attention to risks, not deter use.

Shares of Pfizer closed unchanged at $18.03. Glaxo shares fell 0.3 percent to close at $48.40, while shares of Johnson & Johnson gained 1.2 percent to $66.94. Shares of Abbott rose 0.8 percent to $57.35. All four companies trade on the New York Stock Exchange. (Reporting by Susan Heavey; Editing by Tim Dobbyn)
Business

Latest news on guardian.co.uk

[RobinN]

Hopefully the doctors will remember to mention this aspect of the medication.
I know I never read the box as it was.

[hawke86]

Very good and helpful information.

[Jemma_x]

I am on Tegretol ( carbamazepine ) and since half way through 2007 ive been really depressed and i have had a hard time of things over the past year or so but could taking this be making me worse then i would be if i wasnt on tegretol??

[Belinda5000]

Robin,
Lyrica gave me thoughtsand it was just another on a list of anti-epileptic drugs that did that to me.
My neurologist put me on a anti depressant and I took myself of it eventually.
Belinda

[JLynn]

I have wondered too about the medication Ive been taking for 13-14 years, I cant remember exactly.
Anyway I filled out this questionaire at the doctors office, it asked questions about depression, anxiety, etc. One of the questions was do you have suicidal thoughts, but wouldnt carry them out? My answer in my head was YES! But I marked "No, I do not have suicidal thoughts." In truth I wouldnt kill myself or consider it, but I do have these thoughts, and frequently.
All I ever think is, where do these come from, makes no sense to me because I wouldnt ever do it. I have considered it is from a combo of things, being disconnent with life in general too, I think it all may have to do with how my brain functions, and this duration of my brain being on medication.
Yesterday this doctor added another medication, lamictal, that Im going to start here in the next few days. I am going to wait a day or two and cut back on the increased diazepam, as this drug may help in some ways, its not the miracle it used to be when I first began it. In fact in doesnt even feel like the same drug, and it makes me sick. It honestly only works "right" for about 30 minutes, then I feel drugged, sick, etc.
Its amazing to me that almost any topic I am going through, feeling, whatever is on this board somewhere!

[Belinda5000]

I've been on all 11 of those drugs.and I take Tegretol, Topamax, Clonazepam.
plus I've taken 5 other drugs to boot.

[BuckeyeFan]

One of the questions was do you have suicidal thoughts, but wouldnt carry them out? My answer in my head was YES! But I marked "No, I do not have suicidal thoughts." In truth I wouldnt kill myself or consider it, but I do have these thoughts, and frequently.
All I ever think is, where do these come from, makes no sense to me because I wouldnt ever do it.

Many of us here have had these thoughts including myself. Not to the point where I would even consider doing it, but the thought just pops in at any given time. It is usually more prevalent when I feel overwhelmed, but can show up at anytime, which makes me feel it is not as much depression related as medication triggered.

So many variables in my life to blame it on any one thing.

Stay strong and keep up your good attitude.

[Nancy]

Well, I've sure had those thoughts. It's in my records as "chronic suicide". Chronic??

[hollyking981]

ive had suicidal thoughts and mine were just the fcat that i had E and mine arent under controll either, and have no signs of ever bieng so fra, no med has really been an all rounder for me, non so far have worked, i dont think its the drugm just the dissapointment that i have seziures and what it limits me to do, and the fact there dosent seem to be a light at the end of the tunnel right now, ALTHOUGH i have to say i have improved on "dark thoughts" since being of tegratol, evrything was over dramatised and i felt really inadequate and low XX

[tinasmom]

hollyking-
Although I don't have Epilepsy, I saw the toll it took on my daughter and I can certainly understand your disappointment and depression. Epilepsy not only impacts the person with this disorder, it impacts the entire family. To be a mother and feel so helpless watching your child go through seizures and know that the seizures are not under control is depressing also. Just remember that you have the padded room here to rant about anything you want and we listen and many feel the same pain you do. Also, you have Epilepsy, but Epilepsy does not have you.

[Belinda5000]

hollyking-
Although I don't have Epilepsy, I saw the toll it took on my daughter and I can certainly understand your disappointment and depression. Epilepsy not only impacts the person with this disorder, it impacts the entire family. To be a mother and feel so helpless watching your child go through seizures and know that the seizures are not under control is depressing also. Just remember that you have the padded room here to rant about anything you want and we listen and many feel the same pain you do. Also, you have Epilepsy, but Epilepsy does not have you.

Tinasmom,
I don't believe that me having epilepsy effected my entire family when I was growing up much less now.My seizures aren't controlled .
My family just liked to say you might have a seizure if I did certain things.
It only effects the family if they have the seizures or have had seizures like my husband.

Belinda
he got control after surgery I didn't.

[tinasmom]

Belinda -
My family has been greatly impacted by Epilepsy. I've had to watch my daughter having seizures and I felt so helpless not being able to help her or make these stop. I say the permanent scars in her hands from her nails digging in while seizing. I have had to spend Christmas in the hospital with her because her idiot doctor then put her on her regular dose of meds after she hadn't taken them and she was toxic and ended up with pneunomia. I've had to see her walking into my basement with blood dripping from her face because she had a seizure and she walked to my house because she couldn't drive. Watching her deterioate with all the seizures broke my heart. Seeing her quality of life not what it could be tore me apart. Dealing with all the struggles she went through were my struggles also. Then came the biggest impact ever on my family, I had to bury her at the age of 24 because she died from a seizure. Now, my granddaughter, Nicole, who we adopted has been diagnosed with Epilepsy.

As a mother, my children's struggles are also my struggles. When my children hurt, I hurt. When my children are happy, I am happy. I believe your family has been impacted by Epilepsy, it's just not obvious.