The FDA now requires eight "mood stabilizers" used for the treatment of Bipolar Disorder to carry warning labels saying that they may cause suicidal ideation. What does this mean and what are these medications?
The medications involved in the warning are medications typically used for treating seizures, commonly referred to as "antiepileptics" or "anticonvulsants". They are:
- Depakote (divalproex sodium)
- Gabitril (tiagabine)
- Keppra (levetiracetam)
- Lamictal (lamotrigine)
- Neurontin (gabapentin)
- Tegretol (carbamazepine)
- Topamax (topiramate)
- Trileptal (oxcarbazepine)
The FDA reports that 1 out of 530 patients taking these medications for Bipolar Disorder will experience suicidal ideation or behavior. What is suicidal ideation?
Suicidal ideation means you are feeling suicidal and thinking of plans for committing it, but you have not yet decided to act upon it. Suicidal behavior can mean an actual suicide attempt or a "pseudo" suicide attempt, such as cutting upon yourself without the actual wish to die.
Doctors having contested the report, arguing that the risk of suicide is much higher for patients with Bipolar Disorder who go untreated than that listed for anticonvulsants. That is absolutely true - for patients who actually have Bipolar Disorder. However, if you have been reading this blog or other internet resources on mental health you know that there is a serious concern in the mental health field about Bipolar Disorder being overdiagnosed. If you have actually have trauma, grief, Borderline Personality Disorder or any other issues which are misdiagnosed as Bipolar Disorder - and you are placed on any of the above medications - you can put yourself at risk of creating suicidal ideation or suicidal behavior where there was none before. It's important to think for yourself, educate yourself, and make your own decisions about your mental health and any diagnoses which have been given to you. Doctors and clinicians are only human.
Read the Diagnostic Criteria for Bipolar Disorder and see if this diagnosis actually applies to you. If you truly have Bipolar Disorder, medication is the first line of treatment for the disease. Bipolar Disorder has a heavy biological component and does not respond well to psychotherapy or other non-medicinal interventions. However, if this diagnosis does not fit you, you might want to get a second opinion or look for other options. The medications used to treat Bipolar Disorder are serious medications and should not be taken without proper education and caution.