Lithium therapy may lower suicide risk in bipolar depression
MedWire News: Study findings indicate that lithium therapy may reduce suicide risk in patients with bipolar depression by increasing cortical gray matter (GM) volumes.
"We observed that a positive history of suicide attempts is associated with reduced GM volumes in several brain areas… and that lithium treatment is associated with higher GM volumes in the same regions," the authors explain.
They add that these cortical areas play a role in activities, such as planning of goal-directed behaviors, coping with disappointment, and adapting to change. The authors surmise that a loss of GM in these areas may therefore augment the feelings of hopelessness that often trigger suicide attempts in bipolar patients.
The findings, published in the Journal of Affective Disorders, arise from the assessment of 57 actively depressed bipolar patients. Of these, 19 had attempted suicide in the past and 38 had not.
Patients were classified as lithium-treated (n=18) or untreated (n=39), and all underwent brain imaging to measure GM volume.
Francesco Benedetti (University Vita-Salute, Milan, Italy) and colleagues report that patients taking lithium had a lower severity of depression, measured using the 21-item Hamilton Depression Rating Scale (HDRS), than those not treated with lithium. The former group had a mean HDRS of 21.50 and the latter had a mean HDRS of 24.03.
Compared with patients with no history of suicidal behavior, those who had attempted suicide in the past had lower GM volumes in cortical areas, such as the anterior cingulate cortex, superior temporal cortex, and parieto-occipital cortex.
Lithium-treated patients were found to have higher GM volumes in these suicide-related cortical areas, than untreated patients.
Overall, lithium-free patients with a history of suicide attempts (n=11) had the lowest GM volumes in the group; whereas those treated with lithium and with no suicide history (n=10) had the highest GM volumes of all patients.
Benedetti and team conclude that their findings demonstrate that reduced GM is a risk factor for suicidal behavior, and this risk can be minimized via lithium therapy.
By Lauretta Ihonor