Adjunctive lithium treatment in the prevention of suicidal behaviour in depressive disorders: a randomised, placebo-controlled, 1-year trial.
OBJECTIVE
Evidence based on controlled studies is still limited for treatment strategies that prevent recurrence of suicide attempts. Findings from observational as well as meta-analytic studies strongly suggest that lithium may have suicide-protective properties.


METHODS
Patients with a recent suicide attempt in the context of an affective spectrum disorder (n = 167) were treated with either lithium or placebo during a 12-month period.


RESULTS
Survival analysis showed no significant difference of suicidal acts between lithium and placebo-treated individuals (adjusted hazard ratio 0.517; 95% CI 0.18-1.43). However, post hoc analysis revealed that all completed suicides had occurred in the placebo group accounting for a significant difference in incidence rates (P = 0.049).


CONCLUSIONS
Results indicate that lithium treatment might be effective in reducing the risk of completed suicide in adult patients with affective disorders. Our findings contribute to the growing body of evidence suggesting a specific antisuicidal effect of lithium.
Lauterbach
E
E
Department of Psychiatry and Psychotherapy, University of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. erik.lauterbach@charite.de
Felber
W
W
Müller-Oerlinghausen
B
B
Ahrens
B
B
Bronisch
T
T
Meyer
T
T
Kilb
B
B
Lewitzka
U
U
Hawellek
B
B
Quante
A
A
Richter
K
K
Broocks
A
A
Hohagen
F
F
D000275:Adjustment Disorders / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D019263:Dysthymic Disorder / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D016651:Lithium Carbonate / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment; D055502:Secondary Prevention; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000523:psychology / Q000706:statistics & numerical data; D000092864:Suicide Prevention
D000928:Antidepressive Agents; D016651:Lithium Carbonate