People diagnosed with epilepsy—a condition marked by multiple, unprovoked seizures—are known to have a higher risk for premature death, but it hasn’t always been clear why. Causes related directly to epilepsy, such as accidents or choking during seizures, account for some of the shortened lifespan, but they aren’t nearly common enough to explain why people with the condition have a three-fold higher rate of unnatural death (which includes unintentional injury, homicide, suicide, and poisoning with medication) compared to the general population. Now a study in the journal JAMA Neurology has highlighted some of the specific reasons behind this disparity.
Using hospitalization and mortality records from England and Wales, researchers in the U.K. retrospectively analyzed data from over 58,000 individuals who were diagnosed with epilepsy and taking anti-seizure medications, along with more than 1 million matched (based on sex and age) non-epileptic people from the same data sets. Specifically, the investigators examined the probable causes of death within both groups between the years 2001 and 2014.
They found that people with epilepsy were significantly more likely to die of any unnatural cause than those in the comparison group. Especially large risk increases were noted for both unintentional and intentional self-poisoning with medication, most commonly opioids or psychiatric medications. Previous research has suggested that suicidal behavior and seizures may share some common neurological pathways in the brain. Evidence also shows that people with epilepsy are more likely than average to also have concurrent mental health diagnoses, and therefore to be prescribed and have access to psychotropic drugs.
The authors concluded that, based on the findings, doctors and family members should be more vigilant in counseling patients with epilepsy about medication safety as well as in monitoring them for self-harm behaviors. The findings also point to the need for more research to look at the relationships between the neurological pathways involved in self-injury and those involved in epilepsy.
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