FDA adds suicide warning to epilepsy drugs

WASHINGTON — Drugs used by millions of patients to control epileptic seizures must carry warnings about heightened risks of suicide, federal regulators said Tuesday.

The Food and Drug Administration announcement comes almost a year after the agency first said patients taking the drugs have a slightly higher risk for suicide than those taking dummy pills.

According to the new language, only about 1 in 500 patients faces an increased risk of suicidal thoughts and behavior while taking the drugs. The new warning emphasizes that the risks are about the same among all anti-seizure drugs.

The FDA advised patients to consult their doctor before making any changes to their treatment.

The agency is also requiring manufacturers to distribute pamphlets that describe the risks for patients.

"All patients who are currently taking or starting on any anti-epileptic drug for any indication should be monitored for notable changes in behavior that could indicate the emergence or worsening of suicidal thoughts or behavior or depression," FDA said in a statement.

The new warnings apply to 21 medications, including blockbuster products like GlaxoSmithKline's Lamictal, Johnson & Johnson's Topamax and Pfizer's Lyrica.

The FDA stopped short of adding its sternest warning to the medications, as it had proposed earlier in the year.

In July a panel of outside experts recommended against adding the so-called "black box" warning, the strongest type available. Those experts and other physicians cautioned the agency that a boxed warning about suicide could alarm patients and cause them to stop taking their medications.

Anti-seizure drugs are used for a variety of illnesses besides epilepsy, including migraines, certain nerve-pain disorders, and psychiatric diseases such as bipolar disorder.

London-based Glaxo said it supports the decision to add information about suicide risks to its medication. However, the company added in a statement that it "remains confident in the overall safety and efficacy profile of Lamictal based on our extensive clinical trial experience and the experience of more than 5 million people worldwide."

FDA said in January its analysis of nearly 200 studies of 11 different epilepsy drugs showed patients taking the treatments were more likely to have suicidal thoughts and behaviors.