Of 1397 completed suicides in Finland in one year, all victims (N = 20) that had used lithium in prophylaxis and treatment of a mood disorder during the three final months were carefully examined. Eight victims (40%) fulfilled the criteria of recent adequate lithium prophylaxis. Continuous or intermittent noncompliance with psychopharmacological treatment during the last two years was reported in the majority (85%) of the victims. Only two cases used lithium as a suicide method. The study suggests that problems especially in compliance but also in quality of treatment are likely to limit the usefulness of lithium treatment in suicide prevention.