Research published Wednesday in the NEJM suggests that antiepileptic drugs do not increase the risk of suicide-related events in patients with epilepsy, but do increase the risk of such events in patients with depression and among those who did not have epilepsy, depression, or bipolar disorder.

The research was based on an analysis of more than 5 million patients treated with antiepileptic drugs between 1988 and 2008.

During this period, there were 8212 suicide attempts.

Of those, the incidence of suicide-related events per 100,000 person-years was 15 among patients without epilepsy, depression, bipolar disorder, or antiepileptic-drug treatment; 38.2 among patients with epilepsy who did not receive antiepileptic drugs; and 48.2 among patients with epilepsy who received antiepileptic drugs.

However, in adjusted analyses, the use of antiepileptic drugs was not associated with an increased risk of suicide-related events among patients with epilepsy or bipolar disorder, but was significantly associated with an increased risk among patients with depression and those who did not have epilepsy, depression, or bipolar disorder.

Commenting on the data, study author Alejandro Arana said "in our opinion, in the long term, it is not the drugs themselves that raise the risk of suicide, but the underlying disease for which these drugs are prescribed.

" He added that "treatment with antiepileptic drugs helps to control the psychiatric syndromes that are at the root of suicidal behavior in these patients."

In May 2009, the FDA approved new warnings that suicidal thoughts were higher among patients who received antiepileptic drugs compared with those who had taken a placebo.