NEW YORK (Reuters Health) - Lithium treatment reduces the risk of suicide and suicide attempts in patients with recurrent major depressive disorder, according to findings published in the March issue of the Journal of Clinical Psychiatry.
"Evidence that clinical treatment reduces suicide risk in major depressive disorder (MDD) is limited and inconsistent," Dr. Ross J. Baldessarini, of McLean Hospital, Belmont, Massachusetts, and colleagues note.
Because lithium has shown major antisuicidal effects in bipolar disorder, the team conducted a meta-analysis to assess evidence of antisuicidal effects of lithium in patients with recurrent MDD.
The investigators searched MEDLINE (January 1966 to April 2006) for studies that reported on suicides or suicide attempts during treatment with and without lithium in patients with recurrent MDD. In addition, they added data for 78 new patients provided from the Lucio Bini Mood Disorders Research Center in Sardinia, Italy.
The researchers included eight studies involving 329 subjects (252 with lithium, 205 without lithium, and 128 evaluated with and without lithium) in the analysis. Treatment exposure-observation times with lithium and without lithium were 4.56 years (1149 person-years) and 6.27 years (1285 person-years). The overall risk of suicidal acts was 88.5% lower with versus without lithium: 0.17%/y versus 1.48%/y (incidence rate ratio (IRR) = 8.71, p = 0.0005).
"The findings reported here support the conclusion that lithium may represent a useful supplemental or alternative treatment for potentially suicidal patients with recurrent MDD, as has been found in patients with bipolar disorders," the authors conclude.
