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Introduction Antiepilepticsand benzodiazepines have been associated with increased risk of suicidality. However, in previous studies the severity of depression and anxiety have not been takeninto account as possible confounders. Objectives To find out how antiepileptics and benzodiazepines effect suicidal ideation andother symptoms in general population. Aims To assessthe association between use of antiepileptics or benzodiazepines and suicidalideation in relation to other symptoms of depression and anxiety. Theassociation will be studied in different diagnostic groups in a largepopulation-based cohort. Methods Information on the prescribed medications in the Northern Finland Birth Cohort1966 was collected at the age of 31 years with a postal questionnaire(N=8,211). The presence of suicidal ideation and other symptoms of depressionand anxiety was assessed via the Symptom Checklist –questionnaire. Theassociations between medications and suicidal ideation were studied indifferent diagnostic groups: epilepsy, depression, any non-organic mentaldisorder, and control group. Results There were no difference in suicidal ideation between antiepileptic users(n=54) and non-users (n=8,157) (suicidal ideation mean 1.07 vs. 1.05, p=0.63). Subjectsusing benzodiazepines (n=147) had more suicidal ideation than non-users(n=8,064) (1.29 vs. 1.05, p<0.001). The antiepileptic and benzodiazepineusers had more other depression and anxiety symptoms. When adjusting for thesesymptoms, both antiepileptic and benzodiazepine users had less suicidalideation than non-users. This was found in all diagnostic groups. Conclusions Either use of antiepileptics or benzodiazepines wasnot associated with increased suicidal ideation when symptoms of depression andanxiety were taken into account. [ABSTRACT FROM AUTHOR]

Objectives Midlife progression of schizophrenia shows evidence of longitudinal brain volume decrease and heterogeneous outcomes. Aims We analyzed the relation between brain volume changes, lifetime antipsychotic medication and clinical outcomes. Methods Psychotic members (n= 41) and non-psychotic controls (n=75) of the Northern Finland 1966 Birth Cohort were invited for a MRI brain scan and clinical and cognitive assessment at the age of 34 years (mean 10 years after onset of illness). A follow-up was 9 years later at age 43. Results Clinical outcomes were heterogeneous and generally poor: 10% were recovered. The mean annual whole brain volume reduction was 0.69% in schizophrenia and 0.49 % in controls, especially in temporal lobe and periventricular area. Symptom severity, functioning level, and decline in cognition were generally not associated with volume reduction. However, decline in social and occupational function was associated with supramarginal gyrus reduction and was independent from antipsychotics exposure. Larger amount of antipsychotics over the follow-up associated significantly with larger brain volume loss. Higher doses of lifetime antipsychotic medication were associated to larger decrease of verbal learning change in a 9-year follow-up. Conclusions Brain volume and verbal learning reduction occurs in schizophrenia long after the onset of illness. Antipsychotics may contribute to these reductions. We do not know the real effectiveness and benefits/risks of antipsychotic drugs in schizophrenia from longitudinal and lifespan view. New data does not change current care guidelines but may expand clinical decision making into lower doses, even medication discontinuation in selected groups, and biopsychosocial care. [ABSTRACT FROM AUTHOR]