Extended survival of patients on long-term lithium treatment.

OBJECTIVE

Findings from a recent international multi-centre trial are compatible with the idea that long-term lithium treatment extends the survival of patients suffering from affective disorders to match the general population. A similar reduction of mortality was found in Canadian patients, although important questions remained to be answered about cardiovascular and suicide mortality, and patient selection.

METHOD

Based on data collected in a study (1) from lithium clinics in Canada, Denmark, Germany and Austria, an analysis was carried out of suicide and cardiovascular mortality in patients who received prophylactic lithium treatment.

RESULTS

In patients given lithium for two years or longer (n = 641), both suicide and cardiovascular mortality were the same as, or only slightly higher than, in the general population; in patients given lithium for less than two years (n = 186), both mortalities remained high. The reduced mortality is not likely to be the result of selection because the patients who were treated briefly and those treated for a longer time did not differ in important mortality variables.

CONCLUSIONS

In addition to its ability to prevent recurrences, prophylactic lithium treatment appears capable of reducing both the excess suicide risk and excess cardiovascular mortality of affective illness.