Patients diagnosed with epilepsy in England and Wales are at increased risk of dying from suicide and accidents, according to researchers.
Though the risks of dying unnaturally for people with epilepsy are low in absolute terms (0.3-0.5%), they are higher than in people without epilepsy, noted the study authors.
“Such a detailed examination of specific types of unnatural death has not been carried out until now”
They urged clinicians to advise their patients about unintentional injury prevention and monitor them for suicidal thoughts and behaviour.
The research, conducted at the University of Manchester and Swansea University, was published in the journal JAMA Neurology today.
The team analysed data on 44,678 people with epilepsy compared to 891,429 without epilepsy in England, and 14,051 with epilepsy compared to 279,365 individuals without epilepsy in Wales.
They found that, compared to patients without epilepsy, those with epilepsy were twice as likely to die by suicide and three times more likely to die accidentally.
“We urge clinicians to advise patients about unintentional injury prevention and monitor them for suicidal thoughts”
Patients with epilepsy were also five times more likely to die specifically by accidental medication poisoning, and three and a half times as likely to die by intentional medication poisoning.
Opioid painkillers and mental health drugs were most commonly taken in fatal poisonings among people with and without epilepsy, while fatal overdoses involving antiepileptic drugs were comparatively rare.
Antiepileptic drugs were involved in about 10% of poisoning deaths among people with epilepsy, said the authors of the study funded by the National Institute for Health Research.
Lead study author Dr Hayley Gorton, from Manchester University, said: “People with epilepsy are almost three times more likely to die from any unnatural cause than those without the condition.
“We already know that people with epilepsy are at increased risk of dying prematurely, but such a detailed examination of specific types of unnatural death has not been carried out until now,” she said.
However, Dr Gorton noted that the drivers of the increased mortality risks were not yet fully understood, and it was not possible to speculate with certainty what the “causal mechanisms” were.
But she added: “Because of these risks, it’s important that people with epilepsy are adequately warned so they can take measures to prevent accidents.
“We urge clinicians to advise their patients about unintentional injury prevention and monitor them for suicidal thoughts and behaviour,” she said.
Dr Gorton also advised clinicians to “assess suitability and toxicity of medication when prescribing medicines for other associated conditions to these individuals”.