2010 issue 3-4

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Volume 26, issue 3-4

Review article

Suicidality in Bipolar Disorder

Rafał Jaeschke1, Marcin Siwek1,2,3, Dominika Dudek1,2,3
1. Klinika Psychiatrii Dorosłych Szpitala Uniwersyteckiego w Krakowie
2. Katedra Psychiatrii UJ CM w Krakowie
3. Instytut Farmakologii Polskiej Akademii Nauk w Krakowie
Farmakoterapia w Psychiatrii i Neurologii, 2010, 3-4, 133–140
Keywords: Bipolar disorder, suicide, pharmacotherapy

Abstract

Large suicide risk in course of BD is one of psychiatry's serious problems. Suicidal behaviors take place mainly during depressive or mixed dysphoric episodes. Suicidal risk seems to be similar in patients with BD type I or II.
Proper pharmacotherapy is the most effective way of reducing suicidal risk in BD. Lithium carbonate is the drug of established effectiveness in preventing suicides among the BD patients. Lithium's antisuicidal properties are independent from its mood stabilizing effects. Comparisons of antisuicidal effectiveness of lithium and other mood stabilizers (valproate or carmabazepine) bring mixed results. Indirect data suggest that clozapine, olanzapine and quetiapine might be effective in dealing with suicidal risk among the BD patients. On the contrary, results of longitudinal studies say that antipsychotic drugs might increase suicidal risk in this group of patients. Data concerning the relationship between antidepressants intake and suicidal tendencies in BD are scarce.

Address for correspondence:
Rafał Jaeschke
Klinika Psychiatrii Dorosłych SU
ul. Kopernika 21A, 31–501 Kraków
tel. (12) 424 87 28, fax (12) 424 87 45
e-mail: rafal.jaeschke@gmail.com