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Self-harm and injury less likely with lithium than other drugs

Lithium reduces impulsive aggression as well as stabilising mood in bipolar disorder

Louise Prime

Thursday, 12 May 2016

People with bipolar disorder who are taking lithium are less likely to self-harm or suffer unintentional injury than people with bipolar disorder who are using other commonly prescribed maintenance treatments, research* published in JAMA Psychiatry has shown. The authors said their results showed that lithium is effective in reducing impulsive aggression, as well as in mood stabilisation.

People with bipolar disorder often suffer self-harm leading to illness and injury, although less is known about their risk of unintentional injury. Some evidence has suggested that lithium might reduce the risk of suicidal behaviour, and that anticonvulsants might increase the risk of self-harm. However, little research has been published about the effects of antipsychotics when used as a mood stabiliser treatment. Researchers led from University College London wanted to investigate the matter further.

Using data from a large UK electronic health records database, they analysed rates of self-harm, unintentional injuries and death from suicide among 6,671 people with bipolar disorder who were prescribed lithium, valproate, olanzapine or quetiapine.

The overall number of suicides was too small to draw any conclusions about association with taking any particular drug. But the study authors found that rates of self-harm and unintentional injuries were significantly lower among people taking lithium than those prescribed valproate, olanzapine or quetiapine.

They concluded: “Patients taking lithium had reduced self-harm and unintentional injury rates. This finding augments limited trial and smaller observational study results. It supports the hypothesis that lithium use reduces impulsive aggression in addition to stabilising mood.”


* Hayes JF, Pitman A, Marston L et al. Self-harm, unintentional injury, and suicide in bipolar disorder during maintenance mood stabilizer treatment: a UK population-based electronic health records study. JAMA Psychiatry. 2016; doi: 10.1001/jamapsychiatry.2016.0432.

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