Older, Cheap Drug May Cut Suicide Risk for People With Mood Disorders
Review of data finds that lithium benefits people with depression, bipolar illnesses
Thursday, June 27, 2013
"The study provides further evidence that one of the most effective psychiatric medications for preventing suicide in patients with mood disorders is also one of our oldest," said one expert not connected to the research, Dr. Andrew Kolodny, chairman of psychiatry at Maimonides Medical Center in New York City.
According to background information from the researchers, people with mood disorders have a 30 times higher risk of suicide compared to the general population.
Treatment with mood-stabilizing drugs such as lithium, anticonvulsants or antipsychotics can help maintain mood within normal limits, but their role in suicide prevention has been unclear, according to background information in the review, which was published online June 27 in the journal BMJ.
The review was led by Andrea Cipriani, of the department of psychiatry at Oxford University in the United Kingdom. His team analyzed the results of 48 clinical trials involving more than 6,600 people.
The researchers found lithium to be linked with a 60 percent reduction in the risk of suicide and other causes of death compared with people who took a placebo.
They also found that lithium may reduce the risk of self-harm in people with mood disorders. "[The review] reinforces lithium as an effective agent to reduce the risk of suicide in people with mood disorders," the team said.
How the drug works to cut suicide risk remains unclear. Lithium may reduce relapses of mood disorders, but there also is "some evidence that lithium decreases aggression and possibly impulsivity, which might be another mechanism mediating the anti-suicidal effect," the researchers said.
The drug has many side effects, however, so the researchers said doctors "need to take a balanced view of the likely benefits and harm of lithium in the individual patient."
Dr. Robert Dicker, associate director of the Child/Adolescent Psychiatry Division at Zucker Hillside Hospital in Glen Oaks, N.Y., called the new study "a great reminder that lithium offers tremendous benefits in treating patients with mood disorders and suicide."
But Kolodny said the drug is not used as often as it could be. "Lithium, which is generic and not promoted by pharmaceutical companies, tends to be under-prescribed," he said. "Hopefully, this study will help change that."