Suicidality in Epilepsy: Common With Various Mood and Anxiety Disorders

Research over more than 2 decades indicates anxiety and depression are common among people with epilepsy and associated with an increased risk of poor outcomes, including suicide. Active surveillance data in the United States show that the annual suicide mortality rate in people with epilepsy was 22% higher than in the general population.1 Other population-based case-control studies have demonstrated 3 times or higher risk of suicide among those with epilepsy than controls.2 A bidirectional relation has been documented in which these patients have an increased risk of suicidality before and after the onset of epilepsy, with suicide risk being highest shortly after epilepsy onset.2,3 These findings have led to calls for neurologists to identify and manage depression and anxiety in these patients, including an AAN quality measure for screening anxiety and depression at every clinic visit,4 and a recently published International League Against Epilepsy practice recommendation for depression management in epilepsy.