Tag: preventive meds

Meds & Supplements, Mental Health, News & Research, Treatment

Antiepileptic Drugs Linked to Increased Risk of Suicidal Behaviors and Thoughts

Kerrie Smyres

Patients taking antiepileptic drugs had nearly twice the risk of suicidal behavior or thoughts than those taking a placebo, according to FDA analysis. Epilepsy drugs are commonly prescribed for migraine or headache prevention.

FDA informed healthcare professionals that the Agency has analyzed reports of suicidality (suicidal behavior or ideation) from placebo-controlled clinical studies of eleven drugs used to treat epilepsy as well as psychiatric disorders, and other conditions. In the FDA’s analysis, patients receiving antiepileptic drugs had approximately twice the risk of suicidal behavior or ideation (0.43%) compared to patients receiving placebo (0.22%). The increased risk of suicidal behavior and suicidal ideation was observed as early as one week after starting the antiepileptic drug and continued through 24 weeks. The results were generally consistent among the eleven drugs. The relative risk for suicidality was higher in patients with epilepsy compared to patients who were given one of the drugs in the class for psychiatric or other conditions.

Healthcare professionals should closely monitor all patients currently taking or starting any antiepileptic drug for notable changes in behavior that could indicate the emergence or worsening of suicidal thoughts or behavior or depression.

The drugs included in the analyses include (some of these drugs are also available in generic form):

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

Although the 11 drugs listed above were the ones included in the analysis, FDA expects that the increased risk of suicidality is shared by all antiepileptic drugs and anticipates that the class labeling changes will be applied broadly.

I don’t know anything else right now, but will update you when I learn more.

Meds & Supplements, Resources, Treatment

Epilepsy Drugs (and Headache Preventives) Explained

Kerrie Smyres

The Epilepsy Therapy Development Project‘s website has the most comprehensive information on anticonvulsants that I’ve seen. It is thorough and broken down in a clever way, so that you can see the basics or intermediate or advanced information.

Here are links to the site’s descriptions of epilepsy drugs that are frequently used migraine and headache preventives:

Many thanks to Pam for pointing out the site!

Meds & Supplements, Treatment

Managing Your Period to Manage Migraine

Kerrie Smyres

Lybrel, a continuous birth control pill that stops menstruation recently approved by the FDA, may help prevent menstrually associated migraines for some women. Hormonal birth control is often used as a migraine preventive. Many doctors prescribe that patients replace the sugar pills with active pills to suppress menstruation, thus lessening hormonal fluctuations.

Taken each day, Lybrel provides a continuous supply of hormones without a break for a period, ever. It seems creepy to me, but The Well-Timed Period quotes a report that says that periods aren’t as necessary as they seem. Also, I’m one of the few women who actually likes having a period. (Maybe you didn’t want to know that?)

Learn more about “menstrual management” under “How to Skip a Period” on The Well-Timed Period and pokearound the informative blog.

Meds & Supplements, News & Research, Treatment

Lyrica, Sleep and Chronic Pain

Kerrie Smyres

In studies of Lyrica’s effectiveness for fibromyalgia and shingles pain, participants have reported sleeping better while taking Lyrica.

On his RevolutionHealth blog, sleep specialist Steve Poceta wrote:

Lyrica has been shown to improve sleep in certain patients who have pain, such as fibromyalgia and shingles pain. However, it is also important to assess the effect of a drug on the sleep of normal sleepers, because the sleep of patient groups is by definition already abnormal.

Dr. Poceta also describes the stages of sleep and how different drugs target different areas. Although I had trouble summarizing his points, the explanation isn’t hard to read or understand. I recommend reading it.

For anecdotal evidence, a reader told me that since starting Lyrica in January, her migraines have gone from 3 or 4 times a week to about once a month. Her insurance won’t cover it, even after having her doctor appeal the first decision.

She spends $100 a month on the drug, although she just found a pharmacy that carries it for $72. Proof that shopping around is valuable!

Meds & Supplements, Mental Health, News & Research, Treatment

Preventive Drugs Improve Quality of Life for People With Migraine

Kerrie Smyres

Preventive medications can significantly improve the quality of life for people with migraine, but their quality of life is still below that of people without migraine. The study tested quality of life for patients taking nadolol (Corgard) and topiramate (Topamax). The article, Impact of Preventive Therapy with Nadolol and Topiramate on the Quality of Life of Migraine Patients, appears in the August issue of Cephalalgia.

[R]esearchers studied 76 consecutive migraine patients at least 16 years of age, evaluating them at the beginning of the study and again after 16 weeks of treatment with nadolol at 40 milligrams per day or topiramate at 100 milligrams per day. The study was completed by 61 of the patients.

The results of the Hospital Anxiety and Depression Scale revealed a mild anxiety state and a moderate depressive state at the beginning of the study, which both remained unchanged after therapy.

The migraine-related quality of life questionnaire score indicated statistically significant improvements with treatment.