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Learning About Bipolar Disorder

Suicide Warning Signs

Suicide is a serious risk for individuals with bipolar disorder, particularly during a depressive episode. That's why it's important to be able to recognize the warning signs of suicide and be prepared to do something about them.

Keep in mind that your loved one's suicidal thoughts are related to the fluctuations in brain chemistry associated with bipolar disorder.

As the Depression and Bipolar Support Alliance points out, suicidal thoughts are not "reality." They are the expression of a treatable mental illness.

And remember, you're not alone. Help is available from your loved one's doctor and from suicide prevention hotlines.

Recognize suicide warning signs

Always take your loved one's suicidal behavior seriously. The following are warning signs of suicide:

Talking about or taking physical action to hurt or kill oneself
Looking for ways to kill oneself by seeking access to firearms, pills, or other means
Talking or writing about death, dying or suicide
Talking about feelings of hopelessness
Talking about feelings of rage, anger or wanting revenge
Talking about feelings of anxiety or agitation
Acting recklessly or engaging in risky activities
Increasing alcohol or drug use
Withdrawing from friends, family and society
Appearing to experience dramatic mood changes
Being unable to sleep or sleeping all the time
Giving personal possessions away
Making a will
Expressing feelings that "there is no reason for living" or "there is no purpose in life"

What I can do to help

Here are suggestions about what to do if your loved one exhibits suicide warning signs:

Keep the numbers of the National Suicide Prevention Hotline and doctor near the phone. Be ready to make a call for your loved one. Let your loved one know you are going to get help.
Be direct. Talk openly and matter-of-factly about the warning signs your loved one may be exhibiting. Try not to act shocked, since this can create emotional distance between you.
Be willing to listen. Allow expressions of feelings and show you accept the feelings. Say "I care and I want to help. What can I do?"
Be nonjudgmental. Don't debate whether suicide is right or wrong, or whether your loved one's feelings are good or bad. Don't lecture on the value of life or say "You have so much to live for."
Don't be sworn to secrecy. Seek support from the doctor or a suicide prevention hotline.
Offer hope that alternatives are available, but avoid glib reassurances.
Never leave a person at high risk for suicide alone.
Take action. Remove any means of suicide, such as guns or stockpiled pills.

Remember, help is available. Treat signs of suicidal behavior seriously, and seek immediate help from National Suicide Prevention Hotline at 1-800-273-TALK (1-800-273-8255) or your loved one's doctor.

If your loved one is showing signs of suicidal behavior, call the 24-hour National Suicide Prevention Hotline at 1-800-273-TALK (1-800-273-8255) immediately.

Important Safety Information You Should Know about STAVZOR

Liver problems Your doctor should check your liver function before you start taking STAVZOR and at frequent intervals while you're on therapy. If you feel generally ill (malaise), weak, and tired, if your face is swollen and you lose your appetite, and start vomiting, call your doctor immediately.

Pregnancy: Birth defectsWomen who can become pregnant need to know that valproic acid has been associated with birth defects, in particular with spina bifida, a condition in which the baby's spinal canal fails to close. If you are planning to become pregnant, you should discuss the risks of birth defects, along with other possible treatment options, with your doctor. If you do become pregnant while taking STAVZOR, call your doctor immediately.
Read more important safety information about pregnancy.

PancreatitisSome people taking valproate have experienced a serious, life-threatening illness called pancreatitis (inflamed pancreas). If you experience stomach pain, nausea, vomiting, and/or loss of appetite, call your doctor immediately.

Common side effects reported in studies with valproate were nausea, drowsiness, vomiting, and dizziness. These are not all the side effects that may occur. You will find a complete list of side effects in the full Prescribing Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Recent Information about Antiepileptic Medications including STAVZOR® (valproic acid) Delayed Release Capsules for any use

For Patients and Caregivers

All antiepileptic medicines, used for any condition, may increase suicidal thoughts or actions in some patients. Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. Keep all follow-up visits with the healthcare provider as scheduled. Call the healthcare provider between visits as needed, especially if you have concerns about symptoms.

Watch for and call the healthcare provider right away to report if you or your family member see the appearance or worsening of symptoms of depression, any unusual changes in mood or behavior, or the appearance of suicidal thoughts, behavior, or thoughts about self-harm. Behaviors of concern should be reported immediately to the healthcare provider.

For Healthcare Professionals

All antiepileptic drugs (AEDs), including STAVZOR, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Anyone considering prescribing Stavzor or any other AED must balance their risk of suicidal thoughts and behavior with the risk of untreated illness.

Patients, their caregivers, and families should be informed that AEDs increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of the signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior or thoughts about self-harm. Behaviors of concern should be reported immediately to healthcare providers.

For medical inquiries specific to Stavzor, please call 1-800-455-8070