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The association between gabapentin and suicidality in bipolar patients
Wendy M Leith1, William E Lambert2, James K Boehnlein3
1Forensic Research & Analysis, Lake Oswego.
International Clinical Psychopharmacology
|November 2, 2018
Summary
Gabapentin use in bipolar disorder (BD) patients is associated with a doubled risk of suicidality compared to lithium. This finding highlights potential safety concerns for gabapentin in BD treatment.
Area of Science:
- Psychiatry
- Pharmacovigilance
- Clinical Epidemiology
Background:
- Bipolar disorder (BD) is a serious mental health condition requiring effective treatment.
- Assessing the safety profile of commonly prescribed medications for BD is crucial.
- Gabapentin and lithium are used in BD management, but their comparative risks require investigation.
Purpose of the Study:
- To evaluate the association between gabapentin and suicidality in bipolar disorder patients.
- To compare the risk of suicidality in gabapentin users versus lithium users with BD.
Main Methods:
- Retrospective observational study using US population-based claims data (47,918 BD patients).
- Inclusion criteria: age ≥18, new monotherapy prescription of gabapentin (n=2421) or lithium (n=3101).
- Follow-up up to 1 year; adjusted hazard ratios (HR) calculated using Cox proportional hazards model and propensity score matching.
Main Results:
- Unadjusted incidence rates of suicide/self-harm: 22.9/1000 PY (gabapentin) vs. 11.3/1000 PY (lithium).
- Adjusted HR for suicidality with gabapentin vs. lithium: 2.3 (95% CI: 1.2-4.5).
- Propensity score-matched analysis yielded an adjusted HR of 2.1 (95% CI: 1.02-4.5).
Conclusions:
- Gabapentin use is significantly associated with a twofold increased risk of suicidality in bipolar disorder patients compared to lithium.
- Findings suggest a potential safety concern regarding gabapentin and suicidality in BD.
- Further research and careful monitoring are warranted for gabapentin use in this population.
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