Suicide Risk Among Bipolar Patients

(Ivanhoe Newswire) -- New research shows patients with bipolar disorder who take the most commonly prescribed mood-stabilizing drug in the United States have more than a two-times higher risk of suicide than people who take lithium.

Up to 1.5 percent of people in the United States have bipolar disorder -- a mental illness that is plagued by extreme mood swings that range from elevated mood to severe depression. Experts say the lifetime risk of suicide in patients with the disorder ranges from 8 percent to 20 percent -- 10- to 20-times higher than that of the rest of the population.

Researchers from George Washington Medical Center in Washington, D.C., compared suicide rates of bipolar patients taking lithium to the rates of those on divalproex, commonly known as Depakote. More than 20,630 people aged 14 years and older were included in the study. Patients had at least one filled prescription for lithium, divalproex or another drug between January 1, 1994 and December 31, 2001.

Authors of the study found, “After adjustment for age, gender, health plan, year of diagnosis, comorbid medical or psychiatric conditions, and concomitant use of other psychotropic drugs, risk of completed suicide death was 2.7-times higher during treatment with divalproex than during treatment with lithium.”

The research also shows patients taking divalproex had a 70-percent higher risk for suicide attempts that resulted in an in-hospital stay and an 80-percent increased risk for suicide attempts that required a trip to the ER than those taking lithium. Authors of the study conclude: “This evidence of lower suicide risk during lithium treatment should be viewed in light of the declining use of lithium by psychiatrists in the United States. If lithium does indeed have an antisuicide effect not matched by currently available alternatives, then current prescribing patterns should be reevaluated.”

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SOURCE: Journal of the American Medical Association, 2003;290:1467-1473