Suicidality and antiepileptic drugs: is there a link?

摘要: The main purpose of the present article is to review possible risk factors for suicidal behaviour in epilepsy with a special emphasis on different antiepileptic drugs (AEDs). Epidemiological data show that, general, suicide rate among patients 5-fold higher than that general population, while temporal lobe and complex partial seizures it approximately 25-fold higher. A certain psychiatric comorbidity may provoke suicidality epilepsy, depression cognitive impairment seem be epilepsy. In addition, deterioration share common neuropsychological mechanisms terms hypofrontality. This cause similar psychopathological signs both diagnostic categories, including suicidality. Analysis literature has shown serotonin metabolism disturbances are involved pathogenesis irrespective primary diagnosis. Serotonin also link between depression, even itself. various AEDs differ not only their action, but influences cognition mood epileptic suicidality, respectively. Until now, Ketter's hypothesis been proposed explain psychotropic effects AEDs, although does positive some such as carbamazepine oxcarbazepine. According this model, all result function two types receptor functions: gamma-aminobutyric acid (GABA) ergic antiglutamatergic; other have incorporated. Presumably, neurochemical mechanisms, serotonergic mechanism particular, should taken into account when explaining AEDs. Based these data, suggested properties reduce because they exert antidepressants (i.e. selective reuptake inhibitors), whereas lack would effective prevention. line paradigm, phenobarbital phenytoin proven risk. On hand, carbamazepine, oxcarbazepine, valproate lamotrigine could regarded antisuicidal improve functions patients, possess action. topiramate, tiagabine, vigabatrin, levetiracetam zonisamide, negative cognition, influence evidence-based studies yet. Although zonizamide properties, exerts effects, gabapentin devoid cognition. To more fully paradigm supplemented by an understanding Further trials required prove or refute model.