Reactions 1680, p202 - 2 Dec 2017
Suicidal ideation and increased irritability: 2 case
In a case series, a 79-year-old man developed suicidal
ideation and increased irritability during treatment with
primidone, and a 76-year-old woman developed suicidal
ideation during treatment with levetiracetam and phenytoin
[routes and dosages not stated].
Case 1: A 79-year-old man was admitted following a serious
suicide attempt. He reported taking 30 pills of an unspecified
drug starting with "p" [complete name of the drug not stated].
However, as nothing happened, he attempted suicide by
cutting his wrist twice with a knife. His brother found him half-
an-hour following the event. Four days prior to the admission,
he was started on a treatment with primidone for tremor. He
reported feeling increasingly irritable for the past two days. On
admission, his primidone therapy was discontinued. He
continued to feel non-suicidal with a broad affect.
Case 2: A 76-year-old woman, who had a long history of
epilepsy, was admitted following a suicide attempt by cutting
her both wrists deeply. The cuts were deep and required
tendon repair. She reported that she felt "it was the right thing
to do" at the moment, and also felt acutely depressed after
reading about her medication list and the list of their side
effects. Her son-in-law found her four hours following the
attempt. One day prior to the admission, she was started on a
treatment with levetiracetam. Prior to that, she was on
phenytoin therapy for over 30 years to treat epilepsy. One the
day following the event, she had a complete resolution of
suicidal ideation, and reported having a better mood.
Author comment: "Here we present two cases of
suicidality and their correlation with [antiepileptic drugs]."
Gulwadi A, et al. Case series demonstrating risk of suicidality with antiepileptic
drugs-suicide attempt after 4 days of primidone and 1 day of levetiracetam use.
CNS Spectrums 21: 120, No. 1, Feb 2016. Available from: URL: http://
doi.org/10.1017/S1092852915000905 [abstract] - USA
Reactions 2 Dec 2017 No. 16800114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved