Lithium is associated with decrease in all-cause and suicide mortality in high-risk bipolar patients: A nationwide registry-based prospective cohort study

• Published in: Journal of affective disorders 2015-09, Vol.183, p.159-165
• Main Authors: Toffol, Elena, Hätönen, Taina, Tanskanen, Antti, Lönnqvist, Jouko, Wahlbeck, Kristian, Joffe, Grigori, Tiihonen, Jari, Haukka, Jari, Partonen, Timo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antidepressive Agents - therapeutic use; Attempted suicide; Bipolar; Bipolar Disorder - drug therapy; Bipolar Disorder - epidemiology; Cohort Studies; Female; Finland - epidemiology; Humans; Lithium; Lithium Compounds - therapeutic use; Male; Medicin och hälsovetenskap; Middle Aged; Mortality; Proportional Hazards Models; Prospective Studies; Psychiatry; Psychotropic Drugs - therapeutic use; Registries; Suicide; Suicide - prevention & control; Suicide - statistics & numerical data
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2015.04.055

Abstract Background Mortality rates, in particular due to suicide, are especially high in bipolar patients. This nationwide, registry-based study analyses the associations of medication use with hospitalization due to attempted suicides, deaths from suicide, and overall mortality across different psychotropic agents in bipolar patients. Method Altogether 826 bipolar patients hospitalized in Finland between 1996-2003 because of a suicide attempt were followed-up for a mean of 3.5 years. The relative risk of suicide attempts leading to hospitalization, completed suicide, and overall mortality during lithium vs. no-lithium, antipsychotic vs. no-antipsychotic, valproic acid vs. no-valproic acid, antidepressant vs. no-antidepressant and benzodiazepine vs. no-benzodiazepine treatment was measured. Results The use of valproic acid (RR=1.53, 95% CI: 1.26–1.85, p