Treatment guidelines for young people with epilepsy could be reviewed after a Swedish study found a group of drugs is linked to an increased risk of suicidal behaviour.
The number of prescriptions for gabapentinoids has risen steeply over the past 15 years, but research published in The BMJ warns that there are heightened risks among 15-24-year-olds taking them.
Although previous studies have linked gabapentinoids to suicidal behaviour and overdose-related deaths, findings have been inconsistent there is little data on longer-term harms.
An international research team examined associations between gabapentinoids and a range of harms including suicidal behaviour, unintentional overdose, injuries, road traffic incidents, and violent crime and identified 191,973 people aged 15 years and older who were prescribed pregabalin or gabapentin in Sweden between 2006 and 2013.
Of these, 59% were women, and most were 45 years or older.
After taking account of potentially influential factors, the research team found that during treatment periods, participants were at a 26% increased risk of suicidal behaviour or death from suicide, a 24% increased risk of unintentional overdose, a 22% increased risk of head or body injuries, and a 13% increased risk of road traffic incidents or offences.
When drugs were analysed separately, only pregabalin was associated with increased risks of harm and when researchers looked at age groups, they found that the risks were greatest among 15 to 24 year-olds.
As this was an observational study, the authors have called for further research to better understand the increased risks found in adolescents and young adults prescribed gabapentinoids.
Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: population based cohort study in Sweden. BMJ 13 June 2019.
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