title: Lower suicide risk with long-term lithium treatment in major affective illness: a meta-analysis.
abstract: OBJECTIVE
  To compare suicide rates with vs. without long-term lithium treatment in major affective disorders.
  
  
  METHODS
  Broad searching yielded 22 studies providing suicide rates during lithium maintenance; 13 also provide rates without such treatment. Study quality was scored, between-study variance tested, and suicide rates on vs. off lithium examined by meta-analyses using random-effects regression methods to model risk ratios.
  
  
  RESULTS
  Among 5647 patients (33 473 patient-years of risk) in 22 studies, suicide was 82% less frequent during lithium-treatment (0.159 vs. 0.875 deaths/100 patient-years). The computed risk-ratio in studies with rates on/off lithium was 8.85 (95% CI, 4.12-19.1; P<0.0001). Higher rates off-lithium were not accounted for by treatment-discontinuation.
  
  
  CONCLUSIONS
  Suicide risk was consistently lower during long-term treatment of major affective illnesses with lithium in all studies in the meta-analysis, including the few involving treatment-randomization.
authors.affiliation: Consolidated Department of Psychiatry and Neuroscience Program, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: L
authors.initials: L
authors.lastname: Tondo
authors.forename: J
authors.initials: J
authors.lastname: Hennen
authors.forename: R J
authors.initials: RJ
authors.lastname: Baldessarini
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D013997:Time Factors; D000092864:Suicide Prevention
chemical_list: D008094:Lithium