Report of the WPA section of pharmacopsychiatry on the relationship of antiepileptic drugs with suicidality in epilepsy

INTRODUCTION This report from the World Psychiatric Association Section on Pharmacopsychiatry examines the possible relationship of antiepileptic drugs with suicide-related clinical features and behaviors in patients with epilepsy. MATERIALS AND METHODS A systematic review of the MEDLINE search returned 1039 papers, of which only 8 were considered relevant. A critical analysis of the Food and Drug Administration (FDA) report on the increase risk for patients under antiepileptics to manifest suicidality is also included in this report. RESULTS The analysis of these studies revealed that the data are not supportive of the presence of a "class effect" on suicide-related behavior; on the contrary, there are some data suggesting such an effect concerning treatment with topiramate, lamotrigine, and levetiracetam for which further research is needed. DISCUSSION For the majority of people with epilepsy, anticonvulsant treatment is necessary and its failure for any reason is expected to have deleterious consequences. Therefore, clinicians should inform patients and their families of this increased risk of suicidal ideation and behavior, but should not overemphasize the issue. Specific subgroups of patients with epilepsy might be at a higher risk, and deserve closer monitoring and follow-up. Future research with antiepileptics should specifically focus on depression and suicidal thoughts.

Address of the Trustees of a London Charity School to the Parent of a proposed scholar, 1776 June 24

This two-and-a-half-page handwritten document contains a copy of a set of rules for a parent of a school identified as "Saint Mary Rotherhith United Society."

Vote of the Selectmen of Boston respecting Clarke's children, 1780 August 30

One-page handwritten copy of the vote of the Boston Selectmen responding to Croswell's complaint, as usher of the South Grammar School of Boston, against a parent.

Certificate of the Selectmen of Boston, 1787 August 22

Two handwritten copies of a document certifying Croswell's employment as an usher in the Boston South Public Grammar School.

Recommendation of William Croswell, 1787 November

This folder contains two handwritten documents recommending Croswell as an instructor of literature, languages, and mathematics.

Terms of partnership with Mr. S. Cheney, 1797 August 28

Two leaves containing a handwritten agreement between Samuel Cheney and William Croswell as partners in school-keeping.

Certificate of parent, 1807 June 6

This brief handwritten note, signed by the parent of a Liverpool student, certifies Croswell's proficiency as an instructor.

Dissolution of partnership with Charles Turner, 1808

This folder contains two handwritten documents, dated January 27, 1808, and April 22, 1808, related to the dissolution of the partnership between William Croswell and Charles Turner.

Request to parents of students, 1809 March 21

This brief handwritten note requests a meeting with the parents of Croswell's students in order to continue the school.

List of female students, undated

One-page handwritten list of six girls with their ages and learning goals.

Deed of gift to Sarah Croswell, 1783 August 9

Handwritten list of furniture and an accompanying deed of gift between Andrew Croswell and Sarah Croswell.

Will of the Rev. Andrew Croswell, 1785 November

This folder contains three handwritten copies of the November 8, 1785, will of Andrew Croswell and a copy of the inventory of Croswell's estate.

Receipts related to the dispersal of the Croswell estate, 1785-1788

Seven handwritten receipts dated between 1785 and 1788.