Abstracts

Rationale: The FDA recently analyzed reports of suicidality among patients with epilepsy, primary psychiatric disorders, and other conditions enrolled in eleven antiepileptic drug (AED) trials. Results indicated an increased risk of suicidal ideation or behavior among patients treated with AEDs vs. placebo. Analyses also indicated a higher relative risk in patients with seizure disorders compared to patients receiving AEDs for other conditions. The purpose of this study is to identify the association of suicidality and AED use in patients admitted to MCA's inpatient Epilepsy Monitoring Unit (EMU). Methods: Data was gathered from retrospective chart review of 212 consecutive EMU admissions from 2006 to 2008 who completed full MMPIs as part of their inpatient diagnostic studies. Endorsement of MMPI Critical Item 520 (acknowledgment of current suicidal ideation) was used as the indicator of suicidality. Analyses were run according to patients’ discharge diagnoses (epilepsy, psychogenic nonepileptic spells (PNES), or other). AEDs taken within one week of MMPI administration were recorded. Four patients, who were given more than 1 diagnosis for their spells, were excluded, leaving 208 subjects for data analysis. Results: Subjects consisted of 65 males aged 20 to 78 (M=48.45, SD=15.22) and 143 females aged 18 to 80 (M=44.36, SD=15.25) with a symptom duration (length of AED exposure) ranging from 1 month to 10 or more years (120 months or more). Seven patients endorsed a positive response to Critical Item 520 (Table 2). Binary logistic regression analyses were conducted to determine if AED use increased the odds of patients endorsing current suicidality on the MMPI. Results indicate that, across all patient diagnoses, AED use did not confer a significant risk for endorsing suicidal ideation, χ2(3) = 1.69, p=NS. Findings were similar when the model was run for epilepsy patients only, χ2(1) = .234, p=NS. Conclusions: Our review did not find an increased risk of suicide ideation with AED use in any population based on MMPI responses. The incidence of suicidal ideation appears rare in this inpatient population. Results should be replicated with a prospective trial using a larger sample size to determine if AEDs confer greater risk.