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Suicide-Related Behaviors in Older Patients with New Anti-Epileptic Drug Use: Data from the VA Hospital System

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dc.contributor.author VanCott, Anne C en_US
dc.contributor.author Cramer, Joyce A en_US
dc.contributor.author Copeland, Laurel A en_US
dc.contributor.author Zeber, John E en_US
dc.contributor.author Steinman, Michael A en_US
dc.contributor.author Dersh, Jeffrey J en_US
dc.contributor.author Glickman, Mark E en_US
dc.contributor.author Mortensen, Eric M en_US
dc.contributor.author Amuan, Megan E en_US
dc.contributor.author Pugh, Mary Jo en_US
dc.date.accessioned 2011-12-29T23:09:23Z
dc.date.available 2011-12-29T23:09:23Z
dc.date.copyright 2010 en_US
dc.date.issued 2010-1-11 en_US
dc.identifier.citation VanCott, Anne C, Joyce A Cramer, Laurel A Copeland, John E Zeber, Michael A Steinman, Jeffrey J Dersh, Mark E Glickman, Eric M Mortensen, Megan E Amuan, Mary Jo Pugh. "Suicide-related behaviors in older patients with new anti-epileptic drug use: data from the VA hospital system." BMC Medicine 8:4. (2010) en_US
dc.identifier.issn 1741-7015 en_US
dc.identifier.uri http://hdl.handle.net/2144/2637
dc.description.abstract BACKGROUND: The U.S. Food and Drug Administration (FDA) recently linked antiepileptic drug (AED) exposure to suicide-related behaviors based on meta-analysis of randomized clinical trials. We examined the relationship between suicide-related behaviors and different AEDs in older veterans receiving new AED monotherapy from the Veterans Health Administration (VA), controlling for potential confounders. METHODS: VA and Medicare databases were used to identify veterans 66 years and older, who received a) care from the VA between 1999 and 2004, and b) an incident AED (monotherapy) prescription. Previously validated ICD-9-CM codes were used to identify suicidal ideation or behavior (suicide-related behaviors cases), epilepsy, and other conditions previously associated with suicide-related behaviors. Each case was matched to controls based on prior history of suicide-related behaviors, year of AED prescription, and epilepsy status. RESULTS: The strongest predictor of suicide-related behaviors (N = 64; Controls N = 768) based on conditional logistic regression analysis was affective disorder (depression, anxiety, or post-traumatic stress disorder (PTSD); Odds Ratio 4.42, 95% CI 2.30 to 8.49) diagnosed before AED treatment. Increased suicide-related behaviors were not associated with individual AEDs, including the most commonly prescribed AED in the US - phenytoin. CONCLUSION: Our extensive diagnostic and treatment data demonstrated that the strongest predictor of suicide-related behaviors for older patients newly treated with AED monotherapy was a previous diagnosis of affective disorder. Additional, research using a larger sample is needed to clearly determine the risk of suicide-related behaviors among less commonly used AEDs. en_US
dc.description.sponsorship Department of Veterans Affairs and Health Services Research and Developement Service (IIR-02-274); Virginia Health Services Research and Developement Service Merit Review Entry Program Award (MRP-05-145) en_US
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.rights Copyright 2010 VanCott et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. en_US
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_US
dc.title Suicide-Related Behaviors in Older Patients with New Anti-Epileptic Drug Use: Data from the VA Hospital System en_US
dc.type article en_US
dc.identifier.doi 10.1186/1741-7015-8-4 en_US
dc.identifier.pubmedid 20064226 en_US
dc.identifier.pmcid 2823654 en_US


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Copyright 2010 VanCott et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Except where otherwise noted, this item's license is described as Copyright 2010 VanCott et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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