Citation

Manchia M, Sani G, Alda M. JAMA Psychiatry 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, American Medical Association)

DOI

10.1001/jamapsychiatry.2022.0081

PMID

35262644

Abstract

To the Editor The randomized clinical trial by Katz and coauthors1 adds to the literature on antisuicide properties of lithium in patients with mood disorders. The study enrolled a large number of participants with major depression or bipolar disorder, most with clinically complex presentations--profiles commonly seen in veteran populations. The trial was prematurely terminated following futility analysis. What conclusions can be drawn? The findings contrast with a bulk of naturalistic and epidemiological data showing an evident suicide-protective effect with lithium.2 We concur with the accompanying editorial by Baldessarini and Tondo3 indicating that several factors, including low serum levels of lithium, high rates of psychiatric comorbidity, and the brief treatment exposure, might be responsible for these findings. To wit, Ahrens et al4 concluded that the mortality-reducing effect of lithium can take up to 2 years. As suicide risk varies over time, the study duration in Katz et al1 may have been too short to capture a true pharmacological effect...

Language: en