Bipolar disorder patients on divalproex more likely to commit suicide than those on lithium

Main Category: Bipolar
Article Date: 18 Sep 2003 - 0:00 PDT

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American patients with bipolar disorder who take the most commonly prescribed drug for stabilizing mood are more than twice as likely to commit suicide than those who take lithium.

About one in 67 Americans (1.5%) have bipolar disorder (an illness with extreme mood swings from elevated to severe depression). They are twenty times more likely to commit suicide than the rest of the population.

At George Washington Medical Center researchers compared the suicide rates of bipolar patients on lithium to those on divalproex (Depakote). Of the 20,630 patients studied (aged 14 or more) all had to have had at least one filled prescription of lithium, divalproex (or another drug) between the beginning of 1994 and the end of 2001.

The researchers said "After adjustment for age, gender, health plan, year of diagnosis, comorbid medical or psychiatric conditions, and concomitant use of other psychotropic drugs, risk of completed suicide death was 2.7-times higher during treatment with divalproex than during treatment with lithium.'

They found that patients on divalproex were 70% more likely to commit suicide than those on lithium (attemps that resulted in a hospital stay) and 80% more likely to attempt suicide that resulted in them being taken to an ER.
v The researchers said, 'This evidence of lower suicide risk during lithium treatment should be viewed in light of the declining use of lithium by psychiatrists in the United States. If lithium does indeed have an antisuicide effect not matched by currently available alternatives, then current prescribing patterns should be reevaluated.'