Ng, Vanessa WS;
Leung, Miriam TY;
Chan, Esther W;
Lee, Edwin HM;
Hayes, Joseph F;
Osborn, David PJ;
Wing, Yun Kwok;
... Wong, Ian CK; + view all
(2023)
Association between the mood stabilizing treatment of bipolar disorder and risk of suicide attempts: A self-controlled case series study.
Psychiatry Research
, 325
, Article 115236. 10.1016/j.psychres.2023.115236.
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Abstract
Bipolar disorder (BPD) is associated with high rates of suicide attempts but the anti-suicidal effect of mood stabilizing agents remains unclear. This study aimed to examine the association between mood stabilizing agents (lithium, valproate, lamotrigine, carbamazepine or antipsychotics) and risk of suicide attempts in patients with BPD using self-controlled case series study design. Among 14,087 patients with BPD who received mood stabilizing agents from 2001 to 2020 in Hong Kong, 1316 patients had at least one suicide attempts during the observation period. An increased risk of suicide attempts was observed 14 days before treatment initiation compared to non-exposed period. Following treatment initiation, an increased risk with smaller magnitude was found with the use of mood stabilizing agents. A lower risk was observed with lithium and antiepileptics while the risk remained attenuated with decreasing magnitude with antipsychotics. During 30-day post-treatment period, the risk was elevated. Therefore, this study suggests that use of mood stabilizing agents is not causally associated with an increased risk of suicide attempts. Indeed, there are potential protective effects of lithium and antiepileptics against suicide attempts. Assiduous monitoring of symptoms relapse and warning signs of suicide should be part of the management plan and discussed between clinicians, caregivers and patients.
| Type: | Article |
|---|---|
| Title: | Association between the mood stabilizing treatment of bipolar disorder and risk of suicide attempts: A self-controlled case series study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.psychres.2023.115236 |
| Publisher version: | https://doi.org/10.1016/j.psychres.2023.115236 |
| Language: | English |
| Additional information: | © 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by- nc-nd/4.0/) |
| Keywords: | Lithium, Antipsychotics, Antiepileptics, Within-individual comparison, Electronic health records |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10169579 |
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