Lithium and Suicidal Behaviour in Patients With Bipolar Disorder

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Sir: We read with great interest the excellent article byMarangell et al. In this case-control analysis of the impact oflithium (and other) pharmacotherapy on prospectively observedsuicidal behavior in patients with bipolar disorders, the authorsdid not find an association between lithium (and other moodstabilizer) use and suicide attempts or completed suicides. Thisis in contrast with recent meta-analyses showing that in patientswith major mood disorders, long-term lithium treatmentreduces the risk of suicidal behavior by 60% to 90%.’ ‹