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

Toffol, Elena; Hätönen, Taina; Tanskanen, Antti; Lönnqvist, Jouko; Wahlbeck, Kristian; Joffe, Grigori; Tiihonen, Jari; Haukka, Jari; Partonen, Timo

doi:10.1016/j.jad.2015.04.055

Cited by 59 publications

(37 citation statements)

References 59 publications

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“…Lithium has the best data to support its antisuicidal effects when used in therapeutic doses ( Abou-Saleh et al , 2017 ; Baldessarini et al , 2006 ; Toffol et al , 2015 ). However, miniscule but higher concentrations of lithium in the drinking water are associated with lower rates of suicide in the general population compared with locales with lesser amount of lithium.…”

Section: Resultsmentioning

confidence: 99%

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The New News about Lithium: An Underutilized Treatment in the United States

Post

2017

Neuropsychopharmacol.

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Lithium use for the treatment of mood disorders remains quite low, particularly in the United States compared with some European countries. Mogens Schou pioneered the study of lithium for prophylaxis of the recurrent mood disorder and encouraged its greater use. In an effort to further address the appropriate role of this drug, the multiple assets of lithium beyond its well-known antimanic effect are reviewed, and a brief summary of its side effects is outlined. It appears that lithium has positive effects in depression and suicide prevention, cognition, and reducing the incidence of dementia. It increases the length of telomeres and has positive effects in prevention of some medical illnesses. Lithium side-effect burden, especially its association with end-stage renal disease, may be less than many have surmised. New data indicate the importance of long-term prophylaxis after a first manic episode to lessen episode recurrence, allow cognition to recover to normal, and prevent various aspects of illness progression. After a first manic episode, 1 year of randomized treatment with lithium was superior to that of quetiapine, suggesting the importance of having lithium in the treatment regimen. Given the highly recurrent and progressive course of bipolar disorder sometimes even in the face of conventional treatment, the role and enhanced use of lithium deserves reconsideration.

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Section: Resultsmentioning

confidence: 99%

“…It also increases longevity in humans and several animal species ( Zarse et al , 2011 ). It also reduces all-cause mortality in patients with bipolar disorder ( Toffol et al , 2015 ). Whether any of these effects are secondary to its effects in lengthening telomeres remains to be demonstrated.…”

Section: Resultsmentioning

confidence: 99%

The New News about Lithium: An Underutilized Treatment in the United States

Post

2017

Neuropsychopharmacol.

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“…In a recent review with data from RCTs as well as naturalistic cohort studies Lewitzka et al (5) concluded that "compelling evidence provides strong support that lithium has a suicide protective effect over the long-term course in patients with mood disorders." Its anti-suicidal effect in bipolar disorder was further supported in a recent Finnish nationwide registry-based study among bipolar patients hospitalized because of a suicide attempt between 1996 and 2003 (n=826) (6). The authors looked whether medication use was associated with hospitalization due to attempted suicides, deaths from suicide, and overall mortality during follow-up.…”

Section: What Are the Reasons For This Apparent Discrepancy?mentioning

confidence: 98%

Should we prescribe lithium more often?

Nolen¹

2016

Dusunen Adam

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“…These effects have been confirmed in a recent metanalysis [ 110 ]. Interestingly, although for the most part of anti-suicidal treatments achieve their objective by treating depressive correlates, lithium has been described as reducing suicidal behaviors independently from mood improvement [ 111 ]. A large body of evidence suggests that the anti-suicidal effects of lithium may rely on its action on multiple levels of the suicidal process.…”

Section: Eradicating the Roots Of Suicide: Neurobiological Bases Omentioning

confidence: 99%

Eradicating Suicide at Its Roots: Preclinical Bases and Clinical Evidence of the Efficacy of Ketamine in the Treatment of Suicidal Behaviors

Berardis

Fornaro

Valchera³

et al. 2018

IJMS

151

114

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Despite the continuous advancement in neurosciences as well as in the knowledge of human behaviors pathophysiology, currently suicide represents a puzzling challenge. The World Health Organization (WHO) has established that one million people die by suicide every year, with the impressive daily rate of a suicide every 40 s. The weightiest concern about suicidal behavior is how difficult it is for healthcare professionals to predict. However, recent evidence in genomic studies has pointed out the essential role that genetics could play in influencing person’s suicide risk. Combining genomic and clinical risk assessment approaches, some studies have identified a number of biomarkers for suicidal ideation, which are involved in neural connectivity, neural activity, mood, as well as in immune and inflammatory response, such as the mammalian target of rapamycin (mTOR) signaling. This interesting discovery provides the neurobiological bases for the use of drugs that impact these specific signaling pathways in the treatment of suicidality, such as ketamine. Ketamine, an N-methyl-d-aspartate glutamate (NMDA) antagonist agent, has recently hit the headlines because of its rapid antidepressant and concurrent anti-suicidal action. Here we review the preclinical and clinical evidence that lay the foundations of the efficacy of ketamine in the treatment of suicidal ideation in mood disorders, thereby also approaching the essential question of the understanding of neurobiological processes of suicide and the potential therapeutics.

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

Cited by 59 publications

References 59 publications

The New News about Lithium: An Underutilized Treatment in the United States

The New News about Lithium: An Underutilized Treatment in the United States

Should we prescribe lithium more often?

Eradicating Suicide at Its Roots: Preclinical Bases and Clinical Evidence of the Efficacy of Ketamine in the Treatment of Suicidal Behaviors

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