History of Suicide Prevention with Lithium Treatment

Suicidal behavior is prevalent among individuals with psychiatric illnesses, especially mood, substance abuse, and psychotic disorders. Over the past several decades, lithium treatment in patients with mood disorders has been increasingly used to lower the risk of suicidal behavior. This overview considers that lithium treatment has the most abundant evidence of reducing suicidal behavior. It also examines the hypothesis that higher natural lithium levels in drinking water correlate with reduced suicide rates. We report findings from trials comparing lithium treatment with its absence, placebos, or alternative treatments for suicide prevention and address substantial challenges in such studies. The mechanisms behind lithium's potentially protective effects against suicidal behavior remain uncertain. However, it is believed that lithium may produce anti-aggressive/anti-impulsive effects that directly contribute to anti-suicidal outcomes and mood-stabilizing effects that indirectly lead to the same results. Anti-aggressive/anti-impulsive effects may be obtained at the very low levels of lithium present in drinking water, whereas recurrence prevention may be attained at therapeutic levels.