Current use of newer antiepileptic drugs (AEDs) that pose high risk for depression is associated with increased risk for suicidal behavior, according to an industry-funded study in Neurology. (In 2008, the FDA warned that all AEDs raise suicidality risk.)

Using a U.K. general practice database, researchers matched some 450 patients with epilepsy who had displayed self-harm or suicidal behavior with some 9000 epileptic patients without such behavior. All had used at least one AED during 5.5 years’ follow-up.

Current use of newer AEDs associated with high risk for depression (e.g., levetiracetam, topiramate) raised the odds for self-harm or suicidality threefold, compared with nonuse in the past year. Barbiturates, conventional AEDs (e.g., carbamazepine, phenytoin, valproate), and newer AEDs with low risk for depression (e.g., gabapentin, lamotrigine) did not increase risk.

Editorialists call the study a “good initial attempt” but point out various limitations that might invalidate the findings; for instance, few cases were taking high-risk drugs.