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Review: lithium reduces the risk of suicide compared with placebo in people with depression and bipolar disorder

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Question

Question: Does lithium prevent suicide and self-harm in people with unipolar depression and bipolar disorder?

Outcomes: Suicide, deliberate self-harm (DSH) and all-cause mortality. DSH was defined as a non-fatal outcome following a deliberately initiated behaviour (such as self-cutting) or ingestion of a toxic substance or object with the intention of causing self-harm, irrespective of motivation. Suicidal ideation alone was not considered as an outcome.

Methods

Design: Systematic review and meta-analysis.

Data sources: MEDLINE, EMBASE, CINAHL, PsycINFO and CENTRAL were searched up to January 2013. This was supplemented by hand search of trial registries for published, unpublished and ongoing clinical trials, and contact with study authors and principal manufacturers.

Study selection and analysis: Randomised controlled trials (RCTs) comparing lithium with placebo or with other drugs used in the long-term treatment (≥12 weeks) of mood disorders (diagnosed according to DSM criteria). Eligible studies could include participants of any age or gender; investigate combinations of drugs from the …

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