Lithium and Suicidal Behaviour in Patients With Bipolar Disorder

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Sir: We read with great interest the excellent article by Marangell et al. In this case-control analysis of the impact of lithium (and other) pharmacotherapy on prospectively observed suicidal behavior in patients with bipolar disorders, the authors did not find an association between lithium (and other mood stabilizer) use and suicide attempts or completed suicides. This is in contrast with recent meta-analyses showing that in patients with major mood disorders, long-term lithium treatment reduces the risk of suicidal behavior by 60% to 90%.​

J Clin Psychiatry 2008;69(11):1831-1932