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Vol. 62, No. 1, 2010
Issue release date: June 2010
Section title: Paper
Neuropsychobiology 2010;62:43–49
(DOI:10.1159/000314309)

Lithium Reduces Pathological Aggression and Suicidality: A Mini-Review

Müller-Oerlinghausen B. · Lewitzka U.
aDrug Commission of the German Medical Association, Berlin, and bDepartment of Psychiatry and Psychotherapy, Technical University of Dresden, Dresden, Germany

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Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: 5/7/2010

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 0

ISSN: 0302-282X (Print)
eISSN: 1423-0224 (Online)

For additional information: http://www.karger.com/NPS

Abstract

From a practical point of view, the well-proven antisuicidal and anti-aggressive effects of lithium are of utmost importance for a rational, safe and economical treatment of patients with affective disorders. Regular lithium long-term treatment reduces the otherwise 2- to 3-fold increased mortality of untreated patients with severe affective disorders down to the level of the general population. This is mainly due to the reduced suicide risk. Many international studies have confirmed this fascinating property of lithium which so far has not been demonstrated with comparable evidence for any other psychotropic compound. The antisuicidal effects of lithium might possibly be related to its anti-aggressive effects which have been shown in various species, populations and settings, such as animals, inhabitants of nursing homes for the elderly, mentally handicapped subjects, children and adolescents with hyperactive, hostile and aggressive behavior, and particularly in hyperaggressive inmates of correction units and prisons.


Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: 5/7/2010

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 0

ISSN: 0302-282X (Print)
eISSN: 1423-0224 (Online)

For additional information: http://www.karger.com/NPS


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Grof P, Müller-Oerlinghausen B: A critical appraisal of lithium’s efficacy and effectiveness: the last 60 years. Bipolar Disord 2009;11(Suppl 2):10–19.
  2. Grof P: Sixty years of lithium responders. Neuropsychobiology 2010;62:8–16.

    External Resources

  3. Bauer M, Grof P, Müller-Oerlinghausen B (eds): Lithium in Neuropsychiatry. London, Informa, 2006, pp 33–42.
  4. Lundquist G: Prognosis and cause of manic depressive psychosis. Acta Psychiatr Neurol Scand 1945;35:1–96.
  5. Petterson U: Manic-depressive illness: a clinical, social and genetic study. Acta Psychiatr Scand Suppl 1977;269:55–60.
  6. Tsuang MT, Woolson RF: Excess mortality in schizophrenia and affective disorders. Do suicides and accidental deaths solely account for this excess? Arch Gen Psychiatry 1978;35:1181–1185.
  7. Weeke A: Causes of death in manic depressives; in Schou M, Strömgren E (eds): Origin, Prevention and Treatment of Affective Disorders. London, Academic Press, 1979, pp 289–299.
  8. Hagnell O, Lanke J, Rorsman B: Suicide rates in the Lundby study: mental illness as a risk factor for suicide. Neuropsychobiology 1981;7:248–253.
  9. Tuckman J, Youngman W: Identifying suicide with groups among attempted suicide. Public Health Rep 1963;78:763–766.
  10. Motto I: Suicide attempts: a longitudinal view. Arch GenPsychiatry 1965;13:516–520.
  11. Guze SB, Robins E: Suicide in primary affective disorders. Br J Psychiatry 1970;117:437–438.
  12. Goodwin FK, Jamison KR: Manic-Depressive Illness. New York, Oxford University Press, 1990.
  13. Harris EC, Barraclough B: Excess mortality of mental disorder. Br J Psychiatry 1998;173:11–53.
  14. Ahrens B, Müller-Oerlinghausen B, Schou M, et al: Excess cardiovascular and suicide mortality of affective disorders may be reduced by lithium-prophylaxis. J Affect Disord 1995;33:67–75.
  15. Newman S, Bland R: Suicide risk varies by subtype of affective disorder. Acta Psychiatr Scand 1991;83:420–426.
  16. Ösby U, Brandt L, Correia N, et al: Excess mortality in bipolar and unipolar disorder in Sweden. Arch Gen Psychiatry 2001;58:844–850.
  17. Lester D: Suicidal behavior in bipolar and unipolar affective disorders: a meta-analysis. J Affect Disord 1993;27:117–121.
  18. Angst J, Sellaro R, Angst F: Long-term outcome and mortality of treated vs untreated bipolar and depressed patients: a preliminary report. Int J Psychiatry Clin Pract 1998;2:115–119.

    External Resources

  19. Bottlender R, Jager M, Strauss A, et al: Suicidality in bipolar compared to unipolar depressed inpatients. Eur Arch Psychiatry Clin Neurosci 2000;250:257–261.
  20. Barraclough B: Suicide prevention, recurrent affective disorder and lithium. Br J Psychiatry 1972;121:91–392.
  21. Müller-Oerlinghausen B, Müser-Causemann B, Volk J: Suicides and parasuicides in a high-risk patient group on and off lithium long-term medication. J Affect Disord 1992;25:261–270.
  22. Felber W, Kyber A: Suizide und Parasuizide während und ausserhalb einer Lithiumprophylaxe; in Müller-Oerlinghausen B, Berghöfer A (eds): Ziele und Ergebnisse der medikamentösen Prophylaxe affektiver Psychosen. Stuttgart, Thieme, 1994, pp 53–59.
  23. Coppen A, Standish-Barry H, Bailey J, et al: Does lithium reduce the mortality of recurrent mood disorders? J Affect Disord 1991;23:1–7.
  24. Müller-Oerlinghausen B, Ahrens B, Grof E, et al: The effect of long-term lithium treatment on the mortality of patients with manic-depressive and schizo-affective illness. Acta Psychiatr Scand 1992;86:218–222.
  25. Coppen A: Depression as a lethal disease: prevention strategies. J Clin Psychiatry 1994;55(suppl 4):37–45.
  26. Müller-Oerlinghausen B, Wolf T, Ahrens B, et al: Mortality during initial and during later lithium treatment. A collaborative study by the International Group for the Study of Lithium-treated Patients. Acta Psychiatr Scand 1994;90:295–297.
  27. Baldessarini RJ, Tondo L, Hennen J: Effects of lithium treatment and its discontinuation on suicidal behaviour in bipolar manic-depressive disorders. J Clin Psychiatry 1999;60(suppl 2):77–84.

    External Resources

  28. Baldessarini RJ, Tondo L, Hennen J: Effect of lithium treatment and its discontinuation on suicidal behavior in bipolar manic-depressive disorders. J Clin Psychiatry 1999;60(suppl 2):77–84.

    External Resources

  29. Guzzetta F, Tondo L, Centorrino F, et al: Lithium treatment reduces suicide risk in recurrent major depressive disorder. J Clin Psychiatry 2007;68:380–383.
  30. Kessing LV, Sondergard L, Kvist K, et al: Suicide risk in patients treated with lithium. Arch Gen Psychiatry 2005;62:860–866.
  31. Cipriani A, Pretty H, Hawton K, et al: Lithium in the prevention of suicidal behavior and all-mortality in patients with mood disorders: a systematic review of randomized trials. Am J Psychiatry 2005;162:1805–1819.
  32. Lauterbach E, Felber W, Müller-Oerlinghausen B, et al: Adjunctive lithium treatment in the prevention of suicidal behavior in depressive disorders: a randomized, placebo-controlled 1 year trial. Acta Psychiatr Scand 2008;118:469–479.
  33. Yerevanian BI, Kock RJ, Mintz J: Lithium, anticonvulsants and suicidal behaviour in bipolar disorder. J Affect Disord 2003;73:223–228.
  34. Ahrens B, Müller-Oerlinghausen B: Does lithium exert an independent antisuicidal effect? Pharmacopsychiatry 2001;34:132–136.
  35. Bierbrauer J, Nilsson A, Müller-Oerlinghausen B, et al: Therapeutic and prophylactic effects of lithium on pathological aggression; in Bauer M, Grof P, Müller-Oerlinghausen B (eds): Lithium in Neuropsychiatry. London, Informa, 2006, pp 227–236.
  36. Goodwin FK: Anticonvulsant therapy and suicide in affective disorders. J Clin Psychiatry 1999;60(suppl 2):89–93.

    External Resources

  37. Thies-Fletchner K, Müller-Oerlinghausen B, Seibert W, et al: Effect of prophylactic treatment on suicide risk in patients with affective disorders: data from a randomized prospective study. Pharmacopsychiatry 1996;29:103–107.
  38. Goodwin FK: Rationale for using lithium in combination with other mood stabilizers in the management of bipolar disorder. J Clin Psychiatry 2003;64:18–24.
  39. Sondergard L, Lopez AG, Andersen PK, et al: Mood-stabilizing pharmacological treatment in bipolar disorders and risk of suicide. Bipolar Disord 2008;10:87–94.
  40. Collins JC, McFarland BH: Divalproex, lithium and suicide among Medicaid patients with bipolar disorder. J Affect Disord 2008;107:23–28.
  41. Joffe R: Does lithium save lives? J Psychiatry Neurosci 2004;29:9.
  42. Licht RW, Vestergaard P, Brodersen A: Long-term outcome of patients with bipolar disorder commenced on lithium during hospitalization: a complete 15-year register-based follow-up. Bipolar Disord 2008;10:79–86.
  43. Soares-Weiser K, Bravo Vergel V, Revnun S, et al: A systematic review and economic model of the clinical effectiveness and cost-effectiveness of interventions for preventing relapse in people with bipolar disorder. Health Technol Assess 2007;11:206.
  44. Cade JF: Lithium salts in the treatment of psychotic excitement. Med J Aust 1949;36:349–352.
  45. Forssman H, Walinder J: Lithium treatment of atypical indications. Acta Psychiatr Scand Suppl 1969;207:34–40.

    External Resources

  46. Baastrup P: Practical clinical viewpoints regarding treatment with lithium. Acta Psychiatr Scand Suppl 1969;207:12–18.

    External Resources

  47. Campbell M, Small AM, Green WH, et al: Behavioral efficacy of haloperidol and lithium carbonate. A comparison in hospitalized aggressive children with conduct disorder. Arch Gen Psychiatry 1984;41:650–656.
  48. Campbell M, Adams PB, Small AM, et al: Lithium in hospitalized children with conduct disorder: a double-blind and placebo controlled study. J Am Acad Child Adolesc Psychiatry 1995;34:445–453.
  49. Rifkin A, Karajgi B, Dicker R, et al: Lithium treatment of conduct disorders in adolescents. Am J Psychiatry 1997;154:554–555.
  50. Malone RP, Bennett DS, Luebbert JF, et al: Aggression classification and treatment response. Psychopharmacol Bull 1998;34:41–45.
  51. Carlson GA, Rapport MD, Pataki CS, et al: Lithium in hospitalized children at 4 and 8 weeks: mood, behavior and cognitive effects. J Child Psychol Psychiatry 1992;33:411–425.
  52. Malone RP, Delaney MA, Luebbert JF, et al: A double-blind placebo-controlled study of lithium in hospitalized aggressive children and adolescents with conduct disorder. Arch Gen Psychiatry 2000;57:649–654.
  53. Dostal T, Zvolsky P: Antiaggressive effect of lithium salts in severe mentally retarded adolescents. Int Pharmacopsychiatry 1970;5:203–207.
  54. Micev V, Lynch DM: Effect of lithium on disturbed severely mentally retarded patients. Br J Psychiatry 1974;125:111.

    External Resources

  55. Luchins DJ, Dojka D: Lithium and propanolol in aggression and self-injurious behaviour in the mentally retarded. Psychopharmacol Bull 1989;25:372–375.
  56. Glenn MB, Wroblewski B, Parziale J, et al: Lithium carbonate for aggressive behaviour or affective instability in ten brain-injured patients. Am J Phys Med Rehabil 1989;68:221–226.
  57. Bellus SB, Stewart D, Vergo JG, et al: The use of lithium in the treatment of aggressive behaviours with two brain-injured individuals in a state psychiatric hospital. Brain Inj 1996;10:849–860.
  58. Van Putten T, Sanders DG: Lithium in treatment failures. J Nerv Ment Dis 1975;161:255–264.
  59. Rifkin A, Quitkin F, Carrillo C, et al: Lithium carbonate in emotionally unstable character disorder. Arch Gen Psychiatry 1972;27:519–524.
  60. Prado-Lima P, Knijnik L, Juruena M, et al: Lithium reduces maternal child abuse behavior: a preliminary report. J Clin Pharm Ther 2001;26:279–282.
  61. Dorrego MF, Canevaro L, Kuzis G, et al: A randomized, double-blind, crossover study of methylphenidate and lithium in adults with attention-deficit/hyperactivity disorder: preliminary findings. J Neuropsychiatry Clin Neurosci 2002;14:289–295.
  62. Sheard MH: Effect of lithium in human aggression. Nature 1971;230:113–114.
  63. Tupin JP, Smith DB, Clanon TL, et al: The long-term use of lithium in aggressive prisoners. Compr Psychiatry 1973;14:311–317.
  64. Sheard MH: Lithium in the treatment of aggression. J Nerv Ment Dis 1975;160:108–118.
  65. Sheard MH, Marini JL, Bridges CI, et al: The effect of lithium on impulsive aggressive behaviour in man. Am J Psychiatry 1976;133:1409–1413.
  66. McElroy SL, Pope HG Jr, Keck PE Jr, et al: Are impulse-control disorders related to bipolar disorder? Compr Psychiatry 1996;37:229–240.
  67. Müller-Oerlinghausen B: Lithium long-term treatment – does it act via serotonin? Pharmacopsychiatry 1985;18:214–217.
  68. Coccaro EF: Central serotonin and impulsive aggression. Br J Psychiatry 1989;8(suppl):52–62.
  69. Coccaro EF, Siever LJ, Klar HM, et al: Serotonergic studies in affective and personality disorder patients; correlates with suicidal and impulsive aggressive behavior. Arch Gen Psychiatry 1989;46:587–599.
  70. Coccaro EF, Kavoussi RJ, Sheline YI, et al: Impulsive aggression in personality disorder correlates with tritiated paroxetine binding in the platelet. Arch Gen Psychiatry 1996;53:531–536.
  71. Roggenbach J, Müller-Oerlinghausen B, Franke L, et al: Peripheral serotonergic markers in acutely suicidal patients. 1. Comparison of serotonergic platelet measures between suicidal individuals, nonsuicidal patients with major depression and healthy subjects. J Neural Transm 2007;114:479–478.