The U.S. Food and Drug Administration (FDA) recently issued yet another warning for health care professionals about the increase in suicidal thoughts and behaviors when people are taking certain medications. I've written about other FDA alerts over the past few years involving suicide risk and antidepressants.

Now the FDA says that people taking anticonvulsant medications may also be at greater risk of suicidal thoughts or actual suicide. These medications affect large numbers of people who ordinarily would not be at risk for suicide, because in addition to their use in bipolar disorder, these medications are widely used for epilepsy and sometimes pain disorders and other conditions.

The FDA is not suggesting that these medications not be used. Rather, they want them administered in the safest possible way.

The FDA based its conclusion on research studies involving 11 anticonvulsant drugs (see the list below), which involved nearly 28,000 people in the various medication groups and over 16,000 people taking ineffective placebos. Suicidal thoughts or behaviors were reported by 0.43 percent of the medication-group patients (about 120) and by 0.22 percent of the placebo subjects (about 35).

Although these rates are low, the risk for those taking one of the anticonvulsant medications was double that for those taking placebos. Four people in the medication groups actually committed suicide, while none of the placebo subjects did. This increased risk began within one week of starting the medications and continued for at least 24 weeks, which was as long as many of the studies lasted.

The FDA advisory included the following medications (generic names are followed by brand names):

Carbamazepine - Carbatrol, Equetro, Tegretol, Tegretol XR
Felbamate - Felbatol
Gabapentin - Neurontin
Lamotrigine - Lamictal
Levetiracetam - Keppra
Oxcarbazepine - Trileptal
Pregabalin - Lyrica
Tiagabine - Gabitril
Topiramate - Topamax
Valproate - Depakote, Depakote ER, Depakene, Depacon
Zonisamide - Zonegran

Several of these anticonvulsant medications, such as carbamazepine, lamotrigine, and valproate, are sometimes also taken by people for the treatment of bipolar disorder.

The FDA emphasized that they wanted to make sure that physicians had the most up-to-date information so that patients and their families can be advised of the risk and so that they can be monitored appropriately.

If you are taking any of the drugs listed above, do not stop taking your medication suddenly without first speaking with your doctor.