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New users of the anticonvulsants gabapentin, lamotrigine, oxcarbazepine or tiagabine are at increased risk of suicidal acts compared with new users of topiramate

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Is new use of anticonvulsants associated with an increased risk of suicidal acts or violent death?


297 620 people aged over 15 years of age who began taking an anticonvulsant medication between July 2001 and December 2006 and who had been continuously enrolled in the health plan for 6 months before the first anticonvulsant prescription. Exclusions: Receiving multiple anticonvulsant drugs or attempted suicide or medical condition that could increase the risk of suicidal acts (cancer, HIV or hospitalisation for >30 days) in the 6 months prior to the first anticonvulsant prescription.


14 US states from 1 January 2004 and 3 states from 1 January 2001; the cohort was followed until 31 December 2006.

Risk factors

New use of anticonvulsant medication. The most commonly prescribed anticonvulsants were gabapentin (48% of participants), topiramate (19.4%), lamotrigine (7.5%) and valproate (6.2%), and the less commonly used drugs were carbamazepine, ethosuximide, felbamate, levetiracetam, oxcarbazepine, phenytoin, pregabalin, primidone, tiagabine and zonisamide. Topiramate was chosen as the main comparator drug as it was the second most commonly used drug and is used for a broad …

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  • Sources of funding HealthCore and the Harvard School of Public Health.


  • Competing interests None.

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