The research was conducted by The University of Manchester in collaboration with Professor Ann John and Mr Marcos del Pozo Banos of Swansea University University Medical School. Funded by the NIHR, the research is published in the JAMA Neurology. 

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 says Dr Hayley Gorton from The University of Manchester.

The research team analysed data from 44,678 people with epilepsy compared to 891,429 persons without epilepsy in England and 14,051 people with epilepsy compared to 279,365 individuals without epilepsy in Wales.

The data shows that compared to people without epilepsy, people with epilepsy are specifically:

• Twice as likely to die by suicide.
• Three times more likely to die accidentally.
• Five times more likely to die specifically by accidental medication poisoning.
• Three-and-a-half times as likely to die by intentional medication poisoning.

Opioid painkillers and medicines for mental illness were most commonly taken in fatal poisonings among people with and without epilepsy, whereas fatal overdoses involving antiepileptic drugs were comparatively rare. Antiepileptic drugs were involved in about 10% of poisoning deaths among people with epilepsy.

Dr Gorton said: “Though unnatural death occurs rarely among all groups in the population, 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. However, the direct causes of these increased mortality risks are not yet fully understood. And though the paper identifies an association between mortality and epilepsy, we cannot say for certain what causal mechanisms are implicated". 

Dr Gorton 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. We would also advise doctors to assess suitability and toxicity of medication when prescribing medicines for other associated conditions to these individuals". 

The paper, Risk of Unnatural Mortality in People with Epilepsy, is available here.