So here we go again on how drugs being used to treat mental illness "cause" suicides:
Here's the worst offender: Fierce Pharma
"The FDA issued a sobering warning yesterday: the risk of suicide and suicidal behavior doubles for patients taking epilepsy drugs. Millions are--they're prescribed not only for the seizure disorder but for pain and psychiatric illnesses. The 11 drugs affected include such big-name meds as Pfizer's Lyrica, Abbott Laboratories' Depakote and OrthoMacNeil's Topamax."
First...the study, prompted by a lawyer suing Pfizer, looks at suicidal behavior and thoughts which are NOT associated with suicides. So my friends at FP are wrong. And to associate one drug with increased risk of suicide particularly in a patient population such as individuals suffering with bipolar disorders and comorbidities is just sloppy. But they are not the only ones as we shall see...
Second. Yes, the risk appears to have doubled. But from .022 on placebo to .043 if you are on an anticonvulsant. That means your chance of having nothing go wrong in terms of suicidal thoughts or behavior goes from 99.978 percent on placebo to 99.975 percent. Further, it is unclear from these studies whether patients were receiving other drugs. Most bipolar patients do not receive an anticonvulsant only. There is often combination with lithium, an antidepressant or other medications. So these studies by themselves are not indicative. A better question is what drug combination or what drug best reduces the risk of suicide among people with bipolar conditions.
Here's a much better approach to the subject from the NY Times
F.D.A. Finds Increase in Suicide Symptoms for Patients Using Seizure Medications
By GARDINER HARRIS and BENEDICT CAREY
Published: February 1, 2008
Drugs for epilepsy, bipolar illness and mood problems double the risks of suicidal thoughts and behavior, and patients taking them should be watched for sudden behavioral changes, drug regulators have said.
The increased risks, while double in relative terms, are small. The Food and Drug Administration undertook a combined analysis of 199 clinical trials with 43,892 patients and found 4 suicides and 105 reports of suicidal symptoms among the 27,863 patients who were given the drugs compared to no suicides and 35 reports of suicidal symptoms among the 16,029 patients treated with placebos.
Gardiner Harris and Bennett Carey play it straight and gives patients just the facts.
Good for them and the public.
And last and certainly least...we have one of those phony consumer webzines that are set up by and for trial attorneys to haul in clients with scary headlines. They include newsinferno.com which sadly Fiercepharma cites in their blog. This one is called consumer news weekly and it has fresh story about loved ones losing their lives due to suicides triggered by Topamax...
All we need now is a press release from Grassley's office or Stupak's calling for an investigation. But it's Friday.