Lithium: The key antisuicide agent: Clinical evidence and potential mechanisms

Abstract

Since the early 1970s, extensive clinical evidence supports that lithium is effective in reducing the risk of both attempted and completed suicide in patients suffering from mood disorders. This effect appears to be independent of its mood stabilizer efficiency. This antisuicidal effect is specific to lithium compared with other medications. Despite its clinical effectiveness, the mechanisms by which lithium exerts antisuicidal effects are poorly understood. Several pathways and endophenotypes involved in suicide vulnerability might be improved by a long-term treatment by lithium. This might include a reduction of inflammatory cascade, a restoration of abnormal circadian rhythms, or an action on neuropsychological trait such as decision-making or impulsivity.