To the Editor: Dr Patorno and colleagues1 studied antiepileptic drugs (AEDs) and the risk of suicide, reporting an increased risk of suicide attempts, completed suicide, or violent death in people taking gabapentin, lamotrigine, oxcarbazepine, tiagabine, and valproate, compared with topiramate. In extrapolating these findings to people with epilepsy, several points need to be borne in mind.
First, only a small proportion of the cohort was taking AEDs for epilepsy. Second, the cohort had significant comorbidities, with on average more than 40% taking antidepressants or analgesics. Third, rates were compared with people taking topiramate (for the whole cohort) and with people taking carbamazepine (for people with epilepsy) rather than with the general population.