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ABSTRACT
The article reviews the existing evidence and the concept of the anti-suicidal effect of lithium long-term treatment in bipolar patients. The core studies supporting the concept of a suicide preventive effect of lithium in bipolar patients come from the international research group IGSLI, from Sweden, Italy, and recently also from the U.S. Patients on lithium possess an eight- time lower suicide risk than those off lithium. The anti-suicidal effect is not necessarily coupled to lithium's episode suppressing efficacy. The great number of lives potentially saved by lithium adds to the remarkable benefits of lithium in economical terms. The evidence that lithium can effectively reduce suicide risk has been integrated into modern algorithms in order to select the optimal maintenance therapy for an individual patient.
Notes
In studies investigating potential effects of a therapeutic intervention on suicide rates usually a specific methodical difficulty has to be dealt with: a reasonable estimate has to be created how many cases of deaths are to be expected in a matched, non-treated patient sample. Since mostly it is not possible by ethical reasons to treat a control group of patients suffering from affective disorders with placebo over many years, IGSLI and other research groups used a reference group of the general population. This makes it possible to calculate the standardised mortality rate either for any causes of death or for specific causes such as cardiovascular disease, accident, and suicide
CVS, cardiovascular system.
* = SMR.
(Ahrens et al., Citation1995)
(Ahrens and Müller-Oerlinghausen, Citation1997).