Lithium and suicide prevention in mood disorders and in the general population: A systematic review

Neurosci Biobehav Rev. 2020 Sep;116:142-153. doi: 10.1016/j.neubiorev.2020.06.017. Epub 2020 Jun 16.

Abstract

Suicide contributes to 1-4 % of deaths worldwide every year. We conducted a systematic review aimed at summarizing evidence on the use of lithium for the prevention of suicide risk both in mood disorders and in the general population. We followed the PRISMA methodology (keywords: "lithium", "suicide" AND "suicidal" on Pubmed, Cochrane CENTRAL, Clinicaltrial.gov, other databases). Inclusion criteria: lithium therapy in mood disorder or found in drinking water or scalp in the general population. Exclusion criteria: no lithium administration. From 918 screened references, 18 prospective (number of participants: 153786), 10 retrospective (number of participants: 61088) and 16 ecological studies (total sample: 2062) were included. Most of the observational studies reported a reduction in suicide in patients with mood disorders. All studies about lithium treatment's duration reported that long-term lithium give more benefits than short-term lithium in suicide risk The evidence seems to attribute an intrinsic anti-suicidal property of lithium, independent of its proven efficacy as a mood stabilizer.

Keywords: Bipolar disorder; Drinking Water; Lithium; Major depressive disorder; Recurrent depressive disorder; Schizoaffective disorder; Suicide.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Antimanic Agents / therapeutic use
  • Bipolar Disorder* / drug therapy
  • Humans
  • Lithium / therapeutic use
  • Mood Disorders / drug therapy
  • Prospective Studies
  • Retrospective Studies
  • Suicide* / prevention & control

Substances

  • Antimanic Agents
  • Lithium