Adjunctive lithium treatment in the prevention of suicidal behavior in patients with depression and comorbid personality disorders

Int J Psychiatry Clin Pract. 2014 Oct;18(4):300-3. doi: 10.3109/13651501.2014.940052. Epub 2014 Jul 23.

Abstract

Objective: Patients with both major depression and personality disorders have a high risk of suicidal behavior. Lithium is meant to have anti-suicidal properties in patients with affective disorders. The anti-suicidal effect of lithium in patients with affective disorders and comorbid personality disorders has not been investigated yet.

Methods: A post-hoc analysis of a subsample of patients with depression and comorbid personality disorder (PD) and a recent suicide attempt (n = 19) from the prospective, placebo-controlled lithium intervention study (N = 167), was conducted.

Results: Three patients in the lithium group (n = 8) and two patients in the placebo group (n = 11) presented a suicide attempt throughout the course of the study. No differences related to suicidal behavior could be detected between the placebo group and the group with lithium intervention.

Conclusions: On the basis of the small sample size, among patients with comorbid PD, lithium does not seem to have an effect on suicidal behavior in contrast to patients with affective disorders without comorbid PD.

Keywords: Lithium; affective disorders; major depression; personality disorder; suicide.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / therapeutic use*
  • Depressive Disorder, Major / complications*
  • Depressive Disorder, Major / drug therapy
  • Drug Therapy, Combination
  • Female
  • Humans
  • Lithium Carbonate / administration & dosage
  • Lithium Carbonate / therapeutic use*
  • Male
  • Personality Disorders / complications*
  • Personality Disorders / drug therapy
  • Suicide, Attempted / prevention & control*
  • Young Adult

Substances

  • Antidepressive Agents
  • Lithium Carbonate