What is it about?
Introduction of an anticonvulsant for a Manic/Mixed episode is an independent predictor of suicide attempt in the next two years. After controlling for key variables (clinical and demographic factors, duration of follow-up and time between assessment visits), initiation of treatment with an anticonvulsant was independently associated with the occurrence of a first ever SA event or with SA repetition (in those with a prior history of SA) during follow-up.
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Why is it important?
Management of suicide risk in bipolar disorders is a major issue. This result was obtained in a large sample (more than three thousand patients) with a prospective evaluation of suicide attempts
Perspectives
Our findings indicate the need to develop plausible biological explanations and also have implications for clinical practice. There are several possible mechanisms that could account for the association between initiation of anticonvulsant (mainly valproate) and SA. Investigations on these underlying mechanisms may help the identification of biomarkers of suicidal behaviors.
Frank Bellivier
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This page is a summary of: Anticonvulsants and suicide attempts in bipolar I disorders, Acta Psychiatrica Scandinavica, February 2017, Wiley,
DOI: 10.1111/acps.12709.
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