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Conventional antiepileptic drugs are not associated with an increased risk of suicidal behaviour or self-harm

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Question

Question

Do antiepileptic drugs (AEDs) increase the risk of self-harm and suicidal behaviour?

People

453 cases with self-harm or suicidal behaviour and 8962 age- and sex-matched controls identified using the UK General Practice Research Database (GPRD). Participants were identified from a cohort of 44 300 people with epilepsy or non-febrile seizures who had been treated with at least one prescription for AEDs between 1990 and 2005. The date of cohort entry was date of first AED prescription, and controls were matched with cases for year of cohort entry. The index date for cases was the date of first recorded incident of self-harm or suicidality, and an index date for controls was selected to give an equivalent length of follow-up to their matched case.

Setting

General population, UK; 1990–2005.

Risk factors

Use of AEDs, classified as barbiturates (phenobarbital, primidone, methylphenobarbital), conventional AEDs (carbamazepine, divalproex=valproate, phenytoin, ethosuximide, acetazolamide), newer AEDs with a low risk of causing depression in clinical trials (≤1%; oxcarbazepine, lamotrigine, gabapentin, pregabalin) or newer AEDs with a high risk of causing depression in clinical trials (>1%; levetiracetam, tiagabine, topiramate, vigabatrin). AED exposure was classified as current (prescription lasting into the 14 …

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