Lithium Still Tops in Reducing Suicide Risk in Depression, Bipolar DisorderA new study shows that lithium treatment reduces the risk of suicide in patients with bipolar disorder or depression by more than 60 percent, compared to placebo.

The drug lithium was approved by the FDA in the 1970s for people with mood disorders. With the arrival of other types of mood drugs, such as atypical antipsychotics and anticonvulsants, it became less clear which drugs worked best for the prevention of suicide.

For the study, researchers wanted to see if lithium could reduce suicide rates in patients with depression or bipolar disorder. Of the total 6,674 participants, lithium reduced risk of suicide by more than 60 percent in comparison to lithium placebos.

Forty-two percent of those studied had a history of self-harm and suicide attempts.

After being treated with lithium, however, patients were no longer suicidal, but many were still inclined to self-harm.

While the researchers have found that other non-lithium based drugs are still effective at managing certain symptoms of bipolar disorder and depression, they are not very effective at preventing suicidal thoughts.

Lithium, however, was found to be an effective antisuicidal medication for patients with bipolar disorder or depression. Although the two disorders have different symptoms, the underlying depression connects them.

After treatment with lithium, patients were less aggressive and impulsive. If patients started to experience improvements in their symptoms, they were less likely to relapse back to depression or bipolar disorder symptoms during treatment.

The duration of lithium treatment in order to avoid suicide is very important. The researchers noted that lithium must be used as a long-term treatment for both depression and bipolar disorder and that alternative medications can be considered for shorter therapies.

The researchers suggest that more research should be conducted and have commented, “Understanding the mechanism by which lithium acts to decrease suicidal behavior could lead to a better understanding of the neurobiology of suicide.”

Mood disorders, such as depression and bipolar disorder, are a leading cause of disability, with 32 percent of Americans suffering from these disorders within their lifetime. The suicide rate among people with mental disorders is 30 times higher than the rate among the general population.

Despite the use of medications to manage depression or bipolar disorder, suicide attempts have reached extremely high, and avoidable, levels — men with the disorders are 26 percent more likely to commit suicide.

Source:  BMJ


Reaching for a bottle of medication photo by shutterstock.