Abstract
The management and treatment of patients with suicidal behavior is one of the most challenging tasks for health-care professionals. Patients with affective disorders are at high risk for suicidal behavior, therefore, should be a target for prevention. Numerous international studies of lithium use have documented anti-suicidal effects since the 1970s. Despite the unambiguous evidence of lithium’s anti-suicidal effects and recommendations in national and international guidelines for its use in acute and maintenance therapy of affective disorders, the use of lithium is still underrepresented. The following article provides a comprehensive review of studies investigating the anti-suicidal effect of lithium in patients with affective disorders.
Highlights
Completed and attempted suicides and suicidal thoughts represent complex phenomenon with changing definitions (De Leo et al 2006)
One suicide occurred in the amitriptyline group (n = 41), and no suicides were reported in the lithium group (n = 40)
No suicides were observed in the lithium group (n = 74), while one suicide and one attempted suicide occurred in the carbamazepine group (n = 70) over a 2.5-year follow-up period
Summary
Completed and attempted suicides and suicidal thoughts represent complex phenomenon with changing definitions (De Leo et al 2006). Completed and attempted suicide can cause immense individual and familial distress. Suicide is among the top 20 leading causes of death globally among all ages. Nearly one million people die from suicide (WHO 2014), including approximately 58,000 within the European Union and 10,000 in Germany. In individuals aged 15–39 years, suicide is the second leading cause of death after accidents; the current number of suicide attempts remains unclear. The ratio of suicide attempts to death by suicide in youth is estimated to be approximately 25:1, compared to approximately 4:1 in the elderly (AFSP 2014)
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