Citation

Riblet NB, Shiner B, Young-Xu Y, Watts BV. BJPsych Open 2022; 8(6): e199.

Copyright

(Copyright © 2022, Royal College of Psychiatrists)

DOI

10.1192/bjo.2022.605

PMID

36384820

Abstract

Controversy exists regarding the efficacy of lithium for suicide prevention. Except for a recent trial that enrolled over 500 patients, available trials of lithium for suicide prevention have involved small samples. It is challenging to measure suicide in a single randomised controlled trial (RCT). Adding a single large study to existing meta-analyses may provide insights into lithium's anti-suicidal effects. We performed a meta-analysis of RCTs comparing lithium with a control condition for suicide prevention. MEDLINE and other databases were searched up to 30 November 2021. Efficacy was assessed by calculating the summary Peto odds ratio (OR) and incidence rate ratio (IRR) with 95% confidence intervals. Among seven RCTs, the odds of suicide were lower among patients receiving lithium versus control (OR = 0.30, 95% CI 0.09-1.02; IRR = 0.22, 95% CI 0.05-1.05), although the findings were still not statistically significant. The role of lithium in suicide prevention remains uncertain.

Language: en

Keywords

systematic review; suicide prevention; anti-manic agents; Lithium; randomised controlled trials