New research reveals that all epilepsy drugs are associated with an increased risk for suicide.

The research which appeared in the July 28 issue of the journal Neurology found that certain newer epilepsy medications were linked to an increased risk of suicidal thoughts and behaviors.

The FDA has required a warning on newer and older epilepsy drugs after the agency’s own research review linked use of the medications to a nearly doubled risk of suicidal behaviors or thoughts in patients with epilepsy compared to those taking a placebo.

In the newly reported study, use of the newer epilepsy drugs Keppra, Topamax, and Sabril was associated with the risk of self-harm or suicidal behavior. But other newer epilepsy drugs, including Lamictal, Lyrica, Neurontin, and Trileptal, were found to have no increased risk for such outcomes. And researchers say the study vindicates conventional epilepsy drugs such as Depacon, Depakote, Dilantin, Tegretol, and Zarontin.

Neurologist Josemir W. Sander, MD, of the University College London says studying psychiatric outcomes such as suicidal thoughts and behaviors is difficult in patients with epilepsy because the population is so diverse and subgroups of patients are already at higher risk for depression and suicide.

Clinicians often prescribe the newer drugs along with the older ones only after patients have failed to respond to the older drugs alone which results in drug-refractory epilepsy

Sander also points out that the absolute suicide risk among patients in both studies was very low.

In the newly reported study, which included almost 9,500 epilepsy patients, just two cases of self-harm or suicidal behavior were associated with each of the three drugs identified as potentially high risk.

Epilepsy Foundation spokesman Alan Ettinger says patients need to understand that the risks of not taking drugs that effectively control their seizures are far greater than risks associated with taking the drugs.