Serum lithium levels and suicide attempts: a case-controlled comparison in lithium therapy-naive individuals

Abstract

The present findings suggest that higher serum lithium levels may be protective against suicide attempts in lithium therapy-naive individuals.

The Present State of Lithium for the Prevention of Dementia Related to Alzheimer’s Dementia in Clinical and Epidemiological Studies: A Critical Review

“…Additionally, this necessitates further clinical studies to confirm the aforementioned findings. For example, in the association between suicide rate and lithium in drinking water, we performed clinical studies [2,3] to directly confirm the indirect evidence from epidemiological studies [27][28][29][30] although we could not perform RCTs for that field.…”

“…Similar to the study by Kessing et al (2008), the researchers conducted a Poisson regression analysis, comprising dementia diagnosis as the outcome and the number of prescriptions for lithium, anticonvulsants, antidepressants, and antipsychotics as the variables of interest, with censoring during schizophrenia diagnosis, death, or at the end of the study period (31 December 2005). Continued prescriptions of lithium were associated with a decreased rate of dementia ([number of prescriptions]: [2][3][4], RR = 0.46, 95% CI 0.21-1.01; [5][6][7][8][9], RR = 0.38, 95% CI 0.16-0.86; [10][11][12][13][14][15][16][17][18][19], RR = 0.39 95% CI 0.19-0.81; [20~], and RR = 0.44 95% CI 0.23-0.85). Nonetheless, continued prescriptions of anticonvulsants, antidepressants, or antipsychotics were not significantly associated with a decreased rate of dementia.…”

“…A meta-analysis demonstrated an inverse association between trace lithium levels in drinking water and the total and female suicide mortality rates in epidemiological studies [1]. In clinical studies, for example, Kanehisa et al [2] reported that mean lithium levels in the control group and those in the suicide-attempt group were higher than those in suicide attempters (0.00089 ± 0.00060 mEq/L, 0.00090 ± 0.00046 vs. 0.00068 ± 0.00045 mEq/L) with significant tendency. Multivariate logistic regression analysis with adjustment for age and gender revealed that patients with suicide attempts had significantly lower log-transformed lithium levels than control patients (p = 0.032, odds ratio 0.228, 95% CI 0.059-0.883).…”

Lithium in drinking water and suicide prevention: The largest nationwide epidemiological study from Japan

“…Apart from these epidemiological studies, Kanehisa et al 22 analyzed serum lithium levels of 199 patients including 31 patients with a history of suicide attempts, 21 patients engaging in self‐harm, and 147 control patients. There was a significant difference between the three groups, with patients with a history of suicide attempts having significantly lower lithium levels than control patients; this was however only found in males, not in females.…”

Lithium in drinking water and suicide risk

“…Case-control studies analyzing this have been reported. Kanehisa et al (2017[ 4 ]) reported that the adjusted OR (95 % CI) of subjects with a suicide attempt for a low serum lithium level was 0.228 (0.059–0.883). They considered that higher serum lithium levels might be protective against suicide attempts in lithium therapy-naïve individuals.…”