Migraine

Neuronal stabilizing agents, aka anticonvulsants or antiepileptic drugs, are among the most prescribed medications for Migraine and headache prevention. They're also used to treat some mental health disorders as well as, of course, seizure disorders such as epilepsy.

The FDA has now has analyzed reports of suicidality (suicidal behavior or ideation) from placebo-controlled clinical studies of 11 of these medications and reports that patients receiving antiepileptic drugs had approximately twice the risk of suicidal behavior or ideation (0.43%) compared to patients receiving placebo (0.22%)...

Find out more about this important issue in Risk of Suicidal Thoughts Linked to Anticonvulsant Medications.

Thanks Teri for posting this info - and the last paragraph in your article as well - it's important to keep this in perspective!

I always think with these things it's important not to panic - double the risk sounds horrible but it's doubling from .22 to .43 percent - still a small percentage! What we don't get to see is a comparison with suicide amongst those with uncontrolled seizures or migraines! I know with some anti-depressants they see an increase in suicidal ideation, but I've heard that actual suicides are higher in people with untreated depression!

- Megs

You're welcome, Megs!

IMO, the FDA needlessly scares the bejeebers out of people with some of their warnings because they offer the numbers without giving any perspective.

Another good example of this is their warning about antidepressants, triptans, and serotonin syndrome. They call it a "life-threatening condition," yet when they issued the warning, there were only 27 documented cases, none of them fatal.

You're also right about antidepressatns, suicides, and untreated depression.

They just present figures in rather a vacuum. Grrrrrrrrrrrr.

quote:

Originally posted by nutmegan:
Thanks Teri for posting this info - and the last paragraph in your article as well - it's important to keep this in perspective!

I always think with these things it's important not to panic - double the risk sounds horrible but it's doubling from .22 to .43 percent - still a small percentage! What we don't get to see is a comparison with suicide amongst those with uncontrolled seizures or migraines! I know with some anti-depressants they see an increase in suicidal ideation, but I've heard that actual suicides are higher in people with untreated depression!

- Megs

DH and I were just talking about this when I picked up my first dose of Amitriptyline. It's the first warning on the extra info the pharmacy gives you. So now between that and the Topamax!!! LOL

But a question about suicidal behavior or ideation, since, like I said DH and I were talking about it.

If you don't already have those thoughts - is it still a risk? Is the warning saying that this medication can make you suicidal or that if you already had depression or something of the sort that the feelings may get more intense or worse?

Just curious because as I mentioned with the Amitriptyline - it's technically an anti-anxiety drug, but the first couple nights I took it, all it did was GIVE me anxiety!! figures, right?! I'm all good on it now...the only side effect is me stuffing my face with food!

quote:

Originally posted by EileenHOST:
But a question about suicidal behavior or ideation, since, like I said DH and I were talking about it.

If you don't already have those thoughts - is it still a risk? Is the warning saying that this medication can make you suicidal or that if you already had depression or something of the sort that the feelings may get more intense or worse?

I've often wondered the same thing. Anyone have any ideas?

I had a talk with a psychiatrist about this. He said all it really, clearly, means is that in the study group, x percentage of people taking the drug reported these thoughts. The research folks then have to report it. But he went on to say that there is no way to tell if the drug caused the thoughts, or the people had the thoughts anyway and were just talking about their feelings more on the drug, or what.

Just like on the ADD meds (which both my kids are on), they report a slightly elevated risk of sudden death from heart failure. But the numbers are so low that the heart failures could be completely coincidental. If several people get the flu while in a study group for a drug, they have to report that there's a risk of upper respiratory infection, though it may or may not actually be caused by the drug. That's what this particular doctor told me, anyway.

If you go on the Pub Med site, the government site with a database of medical articles and studies, you can search and read more about all of this - I find it helpful sometimes to hear what the doctors who study these things are saying. (And sometimes I can't make hide nor hair of it all.)

- Megs

That makes sense, Megs. It's the same thing with my anti-nausea meds: both list nausea and vomiting as potential side effects, but I've always wondered if those people just didn't have relief with it or if the med actually caused it. Or like the triptans - they all seem to list headache as a side effect.

Let me add this to the mix:

The other night, I blew up at a troll on a bb that has absolutely no moderator intervention. I found myself wishing I could just go to heaven.

Did I want to die? Of course not!

Did I want to commit suicide? Of course not!

Had I given away prized possessions, or thought about death, or been depressed (more than usual for thyroid disease and migraine and the gajillion other things I have to be depressed about on a regular basis)? Of course not!

But there I was, wishing I could just leave all my problems behind and be with God.

I take Topamax, 100 mg a day.

So what does this mean for me? Don't know. But I'm making a note of it. Since my hysterectomy and since I've been on vivelle-dot for estrogen replacement, I have no mood swings or dips other than those I get after migraine attacks--except now that I'm up to 100 mgs of Topamax. I'm remembering this from when I took Topamax.

We have so, so much suicide in my family--five in my close family alone and more in my huge extended family (I have 33 first cousins on my mother's side alone). I'm keeping close watch.

I have never had suicidal thoughts before. Never been suicidal. Never wanted to die, never wanted to go to heaven before. This scared me to pieces, yes it did.

Edit: just a FWIW: from the list, I've taken Depakote, Neurontin, Zonegran, and Topamax and only the Topamax has caused me to feel this way. I've taken all these for migraine prevention.

From what I read, it's the meds that can cause the suicidal ideation, even if the person has never had such thoughts before.

In the article, I listed the signs to watch for and report.

Thank you for clearing that up. I always wondered if it was just if you already had those types of thoughts or if the medication itself brought those thoughts on.

Now I know!

Eileen - yes, you can have this side effect when you are not already depressed.

My DH and I are still in happy newlywed land

However, after 3 days of depakote I was two seconds away from handing my DH divorce papers because I kept thinking to myself that "I'm not worth being taken care of. You shouldn't waste your time with me. You should just get out now and leave me to die." And sadily this was the day after Christmas when I wrote my first and sadest sharepost. I was sure that my only med option was to to be in constant pain or have the IQ of a rock.

After reading the replies to the post, I realized that what I was thinking was the craziest thing I had ever thought and stopped taking it ASAP.

But I had never even for a moment before that thought of leaving DH. We were not fighting, we were living perfectly happily. I haven't had those thoughts since either. For a while it was like being two people - 1/2 of me was locked up in these horrid thoughts, and the other 1/2 was telling me that my thoughts were ridiculous. Really it was one of the scariest things that had ever happened to me. Like someone else had taken over my brain.

I haven't had a reaction like this to the topamax, or the amitriptyline or a bunch of other meds that list it as a side effect. But the depakote was absolutely horrid. Sometimes I still feel abit guilty for wanting to end my marriage. I know now it was just the meds and not me, but it was still my brain thinking those thoughts.

Teri - should I report reactions to meds like this? The more that I think about it, the more that I could have really hurt myself if I'd kept taking it. I reported it to my doctor but I don't think she even wrote it down. Is this sort of thing better from a doctor than just me?

Laurelin

Laurelin, Teri has a link in her article to the FDA's site where you can report bad reactions to meds. You can find that HERE.

Coincidence or not, when I was on Topamax, I was highly anxious (among other things). I was very miserable. I did isolate myself. I don't think I'd ever give my prized posessions away (when I finally leave this earth, I'd want collections of my work/stuff in my name donated somewhere). I seriously wanted to hurt myself and was afraid I was going to act on it.

I didn't because I have strong spiritual beliefs, wouldn't want to hurt my family & as a therapist I have seen the result of failed suicides at inpatient units (and often there is more reason to be depressed after a failed attempt for a variety of reasons, esp. on a brain injury unit).

When I was much younger, I have had periods of severe (undiagnosed) depression which nothing was done about. Eventually the feelings went away. But what I felt on Topamax was very, very different. It was like I no longer had control of myself.

I'm not scheduled to see Dr. Breathtakingly Arrogant again until June.

Are these sorts of thoughts commonly known to get worse?

Think I should call his office about them?

I would definitely let your doctor know how you felt, especially since it scared you the way it did. It's always better to be on the safe side and keep your doctor informed.

All my best.

quote:

Originally posted by MedievalWriter:
I'm not scheduled to see Dr. Breathtakingly Arrogant again until June.

Are these sorts of thoughts commonly known to get worse?

Think I should call his office about them?