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Risk for suicide is a substantial concern in patients with bipolar disorder, and studies have suggested that lithium treatment might reduce suicide rates in this population. In a 2.5-year, double-blind, randomized study partially supported by the National Institute of Mental Health, investigators compared the effectiveness of lithium and valproate in preventing suicidal behaviors in patients with bipolar disorder who had previously attempted suicide at least once. The study population was 98 patients, stratified by date of suicide attempt (within past year vs. earlier) and by bipolar disorder type. Patients in depressive states also received open-label paroxetine (≤60 mg/day); if they did not respond to paroxetine, they received bupropion o…