H. M.Clary and F. Gilliam addressed this topic in a Neurology publication.1People with epilepsy are prone to depression and anxiety. This is not news forour friends afflicted with seizures. People with epilepsy have a 22% higherrate of epilepsy than the general population.2

The riskof suicidality is highest shortly after the onset of epilepsy. TheInternational League Against Epilepsy practice recommendation calls forneurologists to identify and manage depression and anxiety in their patients atevery clinic visit.

Mood andanxiety diagnoses and suicidality among 347 adults with newly diagnosed focalepilepsy diagnoses were evaluated from the multicenter Human Epilepsy Project.An analysis revealed a high prevalence of psychiatric diagnoses that may go undetected:bipolar disorder, panic disorder, and agoraphobia stood out. There were strongassociations of these diagnoses with suicidality, no different from those withestablished epilepsy.3  

What is Suicidality?The American Psychological Association defines suicidality as “the risk ofsuicide, usually indicated by suicidal ideation or intent, especially asevident in the presence of a well-elaborated suicidal plan.” It also to includessuicidal thoughts, plans, gestures, or attempts.

Bipolardisorder was more common than major depressive disorder. Sixteen percent hadthis diagnosis. Panic disorder was nearly as common as generalized anxiety,present in 11.5% of all participants. Nearly 39% had a mood or anxiety disorderand more than one-third of these had suicidality.

Thisoverall assessment has implications for the clinical care of people withepilepsy as newly diagnosed focal epilepsy and established epilepsy may havesuicide risk associated with psychiatric diagnoses not routinely screened forin epilepsy clinics. This knowledge elevates the need to better detect bipolardisorder, panic disorder and agoraphobia in our clinics.

Do not hesitate to consult withyour physicians and caregivers if you, the patient, or the patient within yourcircle exhibits suicidal thoughts/actions. Do not fear that if you query thepatient of possible suicidality thinking your mentioning the topic could beharmful. No, it’s almost always welcomed and helpful. As always, I recommendsignificant others of the patient accompany the patient to the clinicappointment. Much useful information often comes to light.

1.     Clary H.M., Gilliam F. Suicidalityin Epilepsy. Neurology. 2023: Vol 100; No. 11, p 499-500.

2.     Tian N, Cui W, Zack M et.al. Suicideamong people with epilepsy: a population-based analysis of data from the U.S.National Violent Death Reporting System, 17 states 2003-2011. EpilepsyBehav. 2016, 61:210-217.

3.    KannerA., Saporta A., Kim D, et.al. Mood and Anxiety Disorders and Suicidality inPatients with Newly Diagnosed Focal Epilepsy. Neurology. 2023: vol 100; No.11 p 508-509.

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. Aside from acclamation on internet bookstore sites, U.S. Report of Books, and the Hollywood Book Review, DINGS has been advertised in recent New York Times Book Reviews, the Los Angeles Times Calendar section and Publishers Weekly. DINGS teaches epilepsy and is now  available in eBook, audiobook, soft and hard cover editions.