Epilepsy Talk

Suicide and epilepsy…  | January 10, 2025

We are in a mental health crisis in this community. And not enough is being done to avert it.

According to a peer-reviewed journal article from Epilepsy and Behavior, statistics concluded that people with epilepsy are 22 times more likely to commit suicide than the general population.

And a 29-fold increase in suicide risk was seen in newly diagnosed patients with a history of psychiatric illness.

“Newly diagnosed patients often have many misconceptions about the disease,” researcher Per Sidenius, MD, of Aarhus University says. “They often don’t understand that there are good treatments with few side effects.”

Researchers from Columbia University also reported an increased risk of suicidal thoughts and behaviors in patients who later developed epilepsy.

Among the risk factors contributing to suicidal behavior are surgery (suicide tendency is five times higher than patients taking AEDs), absence of seizures for a long time, especially after being very frequent, and psychiatric conditions such as major depression, anxiety-depression disorders, personality disorders, and substance abuse.

A history of depression increased the risk of epilepsy, but the startling finding was that people with epilepsy were 4 times more likely to have attempted suicide before ever having a seizure, even after other factors were taken into account like drinking alcohol, having depression, age, and gender.

“There is an underlying joint susceptibility to suicide attempts and epilepsy, and it can’t be ignored, because epilepsy in general is more than just seizures,” Dr. Dale Hesdorffer of Columbia University in New York City, told Reuters Health in a telephone interview.

It’s a life or death issue

“Increasingly, clinicians treating people with epilepsy ask about current depression, but they may not ask about past suicide attempt or suicidal thoughts,” said Hesdorffer. “Our results may alert clinicians to the need to ask this question and offer any needed counseling.”

Researcher Dr Jakob Christensen said: “There may be a number of factors that have a major impact on the wellbeing of people with chronic disorders such as epilepsy.”

“We know that epilepsy lowers the overall quality of life of the affected individuals — especially shortly after the diagnosis is given.

“An epilepsy diagnosis affects important parts of people’s lives: job opportunities disappear, patients usually lose their driver’s license, drug treatment may decrease fertility, and pregnancy is associated with an increased risk of congenital malformations of the newborn child.

“The latter may be part of the explanation of why the impact of epilepsy with regard to suicide seems greatest in women.”

In fact, women with epilepsy and a history of psychiatric disease were 23 times more likely to commit suicide than women without either condition, compared with a tenfold increase in risk among men with epilepsy and psychiatric illness.

Medication and the mind

Also, a study, appearing in Neurology, the medical journal of the American Academy of Neurology, has determined that some epilepsy drugs increase the risk for suicide.

People using newer drugs with a higher risk of causing depression such as Keppra, Topamax and Sabril, were three times more likely to harm themselves or attempt suicide than those who were not currently taking any epilepsy drugs.

In contrast, some new drugs have a low risk of causing depression and conventional epilepsy drugs didn’t have any increased risk of self-harm or suicidal behavior.

These groups include drugs such as Lamictal, Neurontin, Tegretol, Depakote and Dilantin.

Since depression reigns supreme, people with both epilepsy and a psychiatric illness were nearly 14 times more likely to commit suicide than people with neither condition.

“Psychological problems, including suicidal thoughts and behaviors, are often not addressed by neurologists who treat epilepsy patients,” Dr. Hesdorffer told Reuters Health. “Many are not comfortable with talking about psychiatric disorders and with talking about suicide attempts.”

“One way to improve management of epilepsy would be for neurologists and psychiatrists to work together to treat patients, which is beginning to happen,” she added. “That will be a fantastic partnership if it continues to develop. It’s at its very early stages now.”

“Physicians, treating patients with epilepsy need to develop collaborations with mental health professionals in order to provide comprehensive treatment to their epilepsy patients.”

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Resources:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518384/

http://www.sciencedaily.com/releases/2007/07/070706143417.htm

http://news.bbc.co.uk/2/hi/health/6253050.stm

http://archpsyc.jamanetwork.com/article.aspx?articleid=2472954

http://phys.org/news/2005-10-links-depression-suicide-epilepsy.html

https://www.epilepsy.com/learn/early-death-and-sudep/suicide-risk

https://www.medscape.com/viewarticle/836165

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