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Lithium, anticonvulsants and suicidal behavior in bipolar disorder
Boghos I Yerevanian1, Ralph J Koek, Jim Mintz
1Ambulatory Care Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. byerevan@ucla.edu
Journal of Affective Disorders
|January 28, 2003
Summary
Mood stabilizers like lithium and anticonvulsants significantly reduce suicide risk in bipolar disorder patients. This study found both medication types offered protection against suicidal behavior in a private practice setting.
Area of Science:
- Psychiatry
- Neuroscience
- Pharmacology
Background:
- Lithium is established for reducing suicide rates in bipolar disorder.
- Limited data exists on anticonvulsant mood stabilizers' efficacy in suicide risk reduction.
Purpose of the Study:
- To compare the effectiveness of lithium versus anticonvulsant mood stabilizers in reducing suicidal behavior in bipolar disorder patients.
- To analyze suicide incidence, attempts, and hospitalizations in patients on monotherapy.
Main Methods:
- Retrospective chart review of 140 bipolar patients over 23 years.
- Data extracted included suicide attempts, completed suicides, and hospitalizations for suicidal ideation.
- Analysis focused on patient-years of treatment 'on' or 'off' lithium or anticonvulsant monotherapy.
Main Results:
- Only one completed suicide occurred during the study period (while off lithium).
- No significant difference in non-lethal suicidal behavior was observed between lithium and anticonvulsant treatment.
- Mood stabilizer treatment, overall, demonstrated a significant protective effect against suicidal behavior.
Conclusions:
- Both lithium and anticonvulsant mood stabilizers are associated with reduced suicidal behavior risk in bipolar disorder.
- No significant difference in protective effects against non-lethal suicidal behavior was found between lithium and anticonvulsants in this naturalistic private practice setting.