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VNA of Care New England

Lithium Cuts Suicide Risk for Patients With Mood Disorders

Review finds reduction in number of suicides, any-cause death for lithium versus placebo
FRIDAY, June 28 (HealthDay News) -- For people with mood disorders, lithium reduces the risk of suicide, according to a review and meta-analysis published online June 27 in BMJ.
Andrea Cipriani, Ph.D., from the University of Verona in Italy, and colleagues conducted a systematic review and meta-analysis to examine whether lithium has a specific preventive effect for suicide and self-harm in people for mood disorders. Forty-eight randomized controlled trials involving 6,674 participants with unipolar and bipolar mood disorders were included.
The researchers found that, compared with placebo, lithium was more effective for reducing the number of suicides (odds ratio [OR], 0.13) and deaths from any cause (OR, 0.38). However, there was no clear benefit seen for lithium in preventing deliberate self-harm (odds ratio, 0.60; 95 percent confidence interval, 0.27 to 1.32). Compared with placebo, lithium correlated with a reduced risk of suicide (OR, 0.36) and the number of total deaths (OR, 0.13) in unipolar depression. Comparing lithium with each active individual treatment, with carbamazepine for deliberate self-harm there was evidence of a significant difference. In general, lithium tended to be better than other active comparators, with little significant variation between the results.
"People treated for an affective disorder have a 30 times greater risk of suicide than the general population, and the evidence that lithium reduces the risk of suicide and possibly deliberate self-harm in people with bipolar disorder and recurrent unipolar depression indicates that lithium should continue to have an important clinical role," the authors write.
One author was an expert witness for Dr. Reddy's Laboratories, and is the chief investigator on a study which is partially funded by GlaxoSmithKline.
Full Text (http://www.bmj.com/content/346/bmj.f3646 )
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