Suicide and Seizures

By: Lance Fogan, MD

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Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. His hard-hitting emotional family medical drama, “DINGS”, is told from a mother’s point of view. “DINGS” is his first novel. It teaches epilepsy, now available in eBook, audiobook, and soft and hard cover editions.

The rate of suicide is increased in people with seizures. The relationship between seizures and suicide is complex and controversial.1 Antiseizure medications have a black-box-warning for suicide indicating their serious relationship.2

Several large studies demonstrate that epilepsy increases the risk of completed suicide and suicide-related-behavior independent of these medications. Are suicidal ideations promoted by changes in neural brain-circuitry-networks that make people with epilepsy more vulnerable to mood disorders?3 These are questions that inspire neuroscience students to research and learn more.

Social stigma and isolation, driving restrictions, substance abuse and decreased employability likely play a major role in depression leading to suicide. People with uncontrollable psychogenic nonepileptic seizures in which they suffer involuntary convulsions (PNES) face similar psychosocial challenges as people with actual epilepsy (see my Blogs # 49 August 27, 2014 “Psychogenic ‘Fake’ Non-Epileptic Seizures; Blog # 99 October 26, 2018 “Revisiting False Epileptic Events” at “Seizures” of PNES do not have an organic cause, however, these “seizures” are just as debilitating and real to the person as actual epileptic convulsions. They are not malingering. Because of the seizures having psychological causes they are notoriously difficult to control. Children seem not to be afflicted with PNES. Education and marriage are associated with decreased risk of suicide. 4

I encourage all persons with epilepsy, their families, and their associates to be aware of a heightened suicide risk and to monitor for a need for professional support.

1. Pompili M, Girardi P, Tatarelli R. Death from suicide versus mortality from epilepsy in the epilepsies; Epilepsy Behav 2006;9:641-648.

2. Hesdorffer DC, Kanner AM. The FDA alert on suicidality and antiepieptic drugs: fire or false alarm? Epilepsia 2009;50:978-986.

3. Kanner AM. Mood disorder and epilepsy: a neurobiologic perspective of their relationship. Dialogues Clin  Neurosc 2008;10:39.

4. Kyung-Sook W, SangSoo S, Sangjin S, Young-Jeon S. Marital status integration and suicide: a meta-analysis and meta-regression. Soc Sci Med 2018;197:116-126.

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