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Article: Association between the mood stabilizing treatment of bipolar disorder and risk of suicide attempts: A self-controlled case series study

TitleAssociation between the mood stabilizing treatment of bipolar disorder and risk of suicide attempts: A self-controlled case series study
Authors
KeywordsAntiepileptics
Antipsychotics
Electronic health records
Lithium
Within-individual comparison
Issue Date10-May-2023
PublisherElsevier
Citation
Psychiatry Research, 2023, v. 325 How to Cite?
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.


Persistent Identifierhttp://hdl.handle.net/10722/331401
ISSN
2023 Impact Factor: 4.2
2023 SCImago Journal Rankings: 2.189
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorNg, VWS-
dc.contributor.authorLeung, MTY-
dc.contributor.authorChan, EW-
dc.contributor.authorLee, EHM-
dc.contributor.authorHayes, JF-
dc.contributor.authorOsborn, DPJ-
dc.contributor.authorWing, YK-
dc.contributor.authorLau, WCY-
dc.contributor.authorMan, KKC-
dc.contributor.authorWong, ICK-
dc.date.accessioned2023-09-21T06:55:23Z-
dc.date.available2023-09-21T06:55:23Z-
dc.date.issued2023-05-10-
dc.identifier.citationPsychiatry Research, 2023, v. 325-
dc.identifier.issn0165-1781-
dc.identifier.urihttp://hdl.handle.net/10722/331401-
dc.description.abstract<p>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. <br></p><p>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.</p>-
dc.languageeng-
dc.publisherElsevier-
dc.relation.ispartofPsychiatry Research-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAntiepileptics-
dc.subjectAntipsychotics-
dc.subjectElectronic health records-
dc.subjectLithium-
dc.subjectWithin-individual comparison-
dc.titleAssociation between the mood stabilizing treatment of bipolar disorder and risk of suicide attempts: A self-controlled case series study-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/j.psychres.2023.115236-
dc.identifier.scopuseid_2-s2.0-85158899294-
dc.identifier.volume325-
dc.identifier.isiWOS:001001152800001-
dc.identifier.issnl0165-1781-

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