Lithium May Be Underused as Antisuicidal Agent, Review Finds

Despite the abundance of evidence published in the past 40 years supporting lithium as an antisuicidal agent, its use is "underrepresented" and should be incorporated into clinical guidelines and practice more assertively.

Although evidence regarding the antisuicidal effects of lithium has been reported over the last 40 years, “the use of lithium is still underrepresented in clinical practice and should be incorporated more assertively into current guidelines,” according to findings of a recent review.

During the review, the study authors aimed to assess the best evidence evaluating the effect of lithium on suicide and self-harm rates. PubMed, PsycINFO, and the Cochrane Library were utilized to obtain systematic reviews and meta-analyses of randomized controlled trials (RCTs) published between January 1980 and June 2017.

Although their search yielded a large number of publications, the study authors only identified 16 systematic reviews. Of these reviews, 4 included data from RCTs only; 3 assessing the effects of lithium on suicide rates and 1 assessing the relationship between lithium use and self-harm. 

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“Despite some methodological concerns and heterogeneity in terms of participants, diagnoses, comparators, durations, and phase of illness, the evidence to date is overwhelmingly in favor of lithium as an antisuicidal agent, even balanced against any potential disadvantages of its use in regular clinical practice,” the authors stated.

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