Suicidal Behavior and Prophylactic Lithium Treatment of Major Mood Disorders: A Review of Reviews

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Abstract
This paper briefly summarizes and discusses at length two recent reviews. Their main findings were the following: (1) During prophylactic lithium treatment the overall mortality of patients with major mood disorders was much lower than in such patients in general. (2) The frequency of suicidal acts was many times lower in patients on lithium than in patients not on lithium. The limitations of the studies reviewed and the difficulty of interpreting their findings are discussed. It is concluded that prophylactic lithium treatment is indicated in patients with major mood disorders who are at high risk of committing suicide, that is, those with severe depressions or depressions with persistent suicidal thoughts or with suicide attempts in the past.