Authors: Goodwin F, et al.
Title: Suicide risk in bipolar disorder during treatment with lithium and divalproex.
Reference: JAMA 2003;290:1467-73.
Purpose: To compare the risk of suicide in patients treated with lithium or valproate.
Study design: Retrospective cohort study.
Follow up: Variable (cross-sectional).
Patients: Drawn from two large health plans: lithium 16,020 person-years, valproate 10,669 person-years.
Treatment: The study assessed bipolar patients with any filled prescription of divalproex or lithium.
Results: Compared with the lithium group, the risk of suicide attempt and death by suicide were elevated in the valproate group by factors of 1.7 and 2.7, respectively.