Zusammenfassung
Dieser Beitrag fasst die aktuelle Datenlage zu suizidalem Verhalten epilepsiekranker Menschen zusammen. Die Suizidraten variieren in der Literatur erheblich, wobei höhere Suizidraten bei schwerer betroffenen Epilepsien (Patienten mit Temporallappenepilepsie, institutionalisierte Patienten, epilepsiechirurgische Patienten) beschrieben wurden. Da alle Antiepileptika potenziell negativ-psychotrop wirken können, ist die Information der Food and Drug Administration (FDA) über diskret erhöhte Suizidraten im Kontext mit Antiepileptikastudien wenig überraschend. Die komplexen Zusammenhänge zwischen Epilepsie, Anfallsaktivität, Therapie und Stimmung bzw. Suizidalität sowie die praktischen Konsequenzen der FDA-Warnung zu Suizidrisiken unter antiepileptischer Medikation werden diskutiert.
Abstract
Recent literature on the frequency of suicidal behavior in epilepsy with respect to potential risk factors is summarized. Suicide rates reported in the literature vary considerably, whereby higher suicide rates have been described for more severe types of epilepsies (patients with temporal lobe epilepsy, institutionalized patients, and patients having undergone epilepsy surgery). Because all anticonvulsants can act as potential negative psychotropic drugs, the information from the Food and Drug Administration (FDA) about an increased suicide rate in context with anticonvulsive medication studies is not surprising. The complex associations between epilepsy, frequency of seizures, treatment as well as mood and suicidality are discussed. The FDA warning of an increased risk for suicidal behavior after the use of anticonvulsants is discussed with respect to the statistical evidence and clinical consequences.
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Schmitz, B. Antiepileptika und Suizidalität bei Epilepsie. Z. Epileptol. 22, 152–155 (2009). https://doi.org/10.1007/s10309-009-0036-y
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DOI: https://doi.org/10.1007/s10309-009-0036-y