Anticonvulsant therapy and suicide risk in affective disorders

Journal/Book: J Clin Psychiat. 1999; 60: P O Box 240008, Memphis, TN 38124, USA. Physicians Postgraduate Press. 89-93.

Abstract: Patients with major affective disorders are more likely to complete suicide than patients in any other medical group. Established risk factors for completed suicide in affective disorders include acute depression (with turmoil, hopelessness, global insomnia, anhedonia, anxiety and/or panic), mixed episodes, rapid cycling, substance abuse, aggression and/or impulsivity, low serotonergic activity, and hypothalamic-pituitary-adrenal axis activation. Although anticonvulsants have mood-stabilizing and antidepressant properties, few data are available on the antisuicide effects of anticonvulsant treatment in manic-depressive patients. On the other hand, as reviewed elsewhere in this issue, massive data have been accumulated on the antisuicide effect of Lithium. This article discusses lithium versus anticonvulsants in the prevention of suicide associated with affective disorders and future treatment strategies to reduce this most serious complication of manic-depressive illness.

Note: Article Goodwin FK, Ctr Neurosci Med Progress & Soc, 2150 Penn Ave NW, Washington,DC 20037 USA

Keyword(s): LITHIUM CARBONATE PROPHYLAXIS; BIPOLAR AFFECTIVE-DISORDER; MAJOR AFFECTIVE-DISORDERS; ACUTE MANIA; VALPROATE; CARBAMAZEPINE; GABAPENTIN; TRIAL; LAMOTRIGINE; DIVALPROEX

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