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Lithium reduces risk of suicide in people with mood disorders, review finds

Date:
June 27, 2013
Source:
BMJ-British Medical Journal
Summary:
The drug lithium is an effective treatment for reducing the risk of suicide and possibly deliberate self harm in people with mood disorders, an evidence review finds.

The drug lithium is an effective treatment for reducing the risk of suicide and possibly deliberate self harm in people with mood disorders, finds an evidence review published today on bmj.com.

The authors say the drug "seems to reduce the risk of death and suicide by more than 60% compared with placebo" and suggest this review "reinforces lithium as an effective agent to reduce the risk of suicide in people with mood disorders."

Mood disorders are a leading cause of global disability. The two main types are unipolar disorder (often called clinical depression) and bipolar disorder (often called manic depression). Both are serious, long term conditions involving extreme mood swings, but people with bipolar depression also experience episodes of mania or hypomania.

People with a mood disorder have a 30 times greater risk of suicide than the general population. Treatment with mood stabilising drugs like lithium, anticonvulsants or antipsychotics can help keep mood within normal limits, but their role in suicide prevention is still uncertain.

So a team of researchers from the universities of Oxford, UK and Verona, Italy set out to assess whether lithium has a specific preventive effect for suicide and self harm in people with unipolar and bipolar mood disorders.

They reviewed and analysed the results of 48 randomised controlled trials involving 6,674 participants. The trials compared lithium with either placebo or active drugs in long term treatment for mood disorders.

Lithium was more effective than placebo in reducing the number of suicides and deaths from any cause, but no clear benefits were seen for lithium compared with placebo in preventing deliberate self harm.

When lithium was compared with each active individual treatment, a statistically significant difference was found only with carbamazepine for deliberate self harm. Overall, lithium tended to be generally better than the other active treatments, with small statistical variation between the results.

"This updated systematic review reinforces lithium as an effective agent to reduce the risk of suicide in people with mood disorders," say the authors.

They suggest that lithium may exert its anti-suicidal effects "by reducing relapse of mood disorder," but add "there is some evidence that lithium decreases aggression and possibly impulsivity, which might be another mechanism mediating the anti-suicidal effect."

They acknowledge that lithium has several side effects, but say clinicians "need to take a balanced view of the likely benefits and harm of lithium in the individual patient." And they conclude: "Understanding the mechanism by which lithium acts to decrease suicidal behaviour could lead to a better understanding of the neurobiology of suicide."


Story Source:

The above story is based on materials provided by BMJ-British Medical Journal. Note: Materials may be edited for content and length.


Journal Reference:

  1. A. Cipriani, K. Hawton, S. Stockton, J. R. Geddes. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis. BMJ, 2013; 346 (jun27 4): f3646 DOI: 10.1136/bmj.f3646

Cite This Page:

BMJ-British Medical Journal. "Lithium reduces risk of suicide in people with mood disorders, review finds." ScienceDaily. ScienceDaily, 27 June 2013. <www.sciencedaily.com/releases/2013/06/130627190655.htm>.
BMJ-British Medical Journal. (2013, June 27). Lithium reduces risk of suicide in people with mood disorders, review finds. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2013/06/130627190655.htm
BMJ-British Medical Journal. "Lithium reduces risk of suicide in people with mood disorders, review finds." ScienceDaily. www.sciencedaily.com/releases/2013/06/130627190655.htm (accessed July 31, 2014).

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