Scientists expect that lithium can reduce that risk by more than 60 percent, based on a study from the University of Oxford published in the British Medical Journal, although folks living with a mood disorder face a 30 times greater danger of suicide in relation to the general population.
Lithium is a commonly used drugs for psychiatric illnesses, particularly bipolar disorder and depression. Previous studies found that lithium might play a role in reducing suicide rates associated with one of these conditions, but larger samples were recommended for future studies.
The University of Oxford study examined 48 trials from 1968 to 2013 involving 6,674 participants. The study was 70 percent bigger than any previous studies to analyze the advantages of lithium.
On the results of several other drugs relative to a placebo, trial participants were examined as well as lithium. These drugs comprised: amitriptyline, carbamazepine, valproate (including divalproex), fluoxetine, fluvoxamine, imipramine, lamotrigine, mianserin, maprotiline, nortriptyline, olanzapine, phenelzine, quetiapine, and thyroid hormone.
Lithium treatment resulted in fewer departures and fewer suicides from another cause when compared with a placebo. Lithium additionally revealed some benefit for preventing cases of self harm, although the correlation wasn’t as powerful.
“Lithium continues to be used for suicide prevention for 30 years,” said Edward Shorter, PhD FRSC, professor of psychiatry at University of Toronto, who was not affiliated with all the study. “All studies, except for one in 2005, have shown that it may prevent suicide. If taken consistently, can keep you illness free. Preventing suicide is vital, but it’s not the only good thing about lithium.”
But, the upgraded analysis further supports that lithium is among the very effective treatment options for suicide prevention, and certainly showed a decreased danger of suicide and death of more than 60 percent in comparison with a placebo.
While the benefits of lithium versus other active drugs weren’t considered to be significant, study authors did note that lithium performed better in reducing episodes of self harm.
Researchers attributed the reduced suicide danger to the ability to reduce mood disorder relapses of lithium, and proposed the drug may additionally decrease impulsivity and aggression.
“This updated systematic review strengthens lithium as an effective agent to lessen the chance of suicide in individuals with mood disorders,” said the study authors. “Understanding the mechanism by which lithium acts to decrease suicidal behavior could lead to an improved knowledge of the neurobiology of suicide.”
Despite adverse effects, lithium therapy needs to be regarded as part of the clinical decision making process that weighs the advantages and disadvantages of treatment, the study reasoned.
Treatment Options for Suicide Prevention
Some patients may not want to take on the added negative effects related to lithium treatment, which include nausea, headache, tremor of hands, dehydration, and lithium toxicity through overdose.
“The advantages of lithium are appreciable, as well as the adverse effects only affect a tiny minority,” said Dr. Shorter. “They can contain loss of renal function, however this is uncommon. Many patients stay on lithium for decades without the side effects.”
Alternative options comprise other mood stabilizing drugs, and electroconvulsive therapy.
“Mood stabilizers also have some effect in suicide prevention, and some don’t have the side effects of lithium,” described Shorter. “But the key choice is electroconvulsive therapy (ECT), which can be super powerful to prevent suicide, and has unjustly received negative reputation.”
ECT, often called electroshock therapy, induces contentious and greatly opposed treatment alternatives, due to the graphical nature of the procedure. The therapy requires patients to be put under general anesthesia and muscle relaxers before receiving electric pulses
Unwanted side effects range from severe short-term memory decline, causing the FDA to claim it’s a high risk option — a view Dr. Shorter and the American Psychiatric Association differ with.
“I ‘d recommend ECT over lithium. In case your patient is suicidal, ECT is the top treatment,” reasoned Shorter.