Do Lithium and Valproate Protect Against Suicidal Acts?

Few studies have directly compared the potential suicide-protective benefits of lithium and valproate. In a “within-individual” Swedish registry study, researchers examined rates of suicides and attempts during periods on versus off lithium or valproate.

Data from 2005 through 2013 were analyzed on 51,535 individuals with bipolar I or II disorder, bipolar disorder not otherwise specified, or schizoaffective disorder/bipolar type. Overall, 9% of subjects had least at one suicide event, 1% died by suicide, and 50% had never received lithium or valproate.

There were 4045 patients with at least one suicidal event (10,403 events) who met other criteria to permit the within-individual analysis. The suicide event rate was 14% lower during on-lithium…