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 Cana dian patients, although important questions remained to be answered ab out cardiovascular and suicide mortality, and patient selection. Metho d: Based on data collected in a study (1) from lithium clinics in Cana da, Denmark, Germany and Austria, an analysis was carried out of suici de 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 p atients given lithium for less than two years (n = 186), both mortalit ies remained high. The reduced mortality is not likely to be the resul t of selection because the patients who were treated briefly and those treated for a longer time did not differ in important mortality varia bles. Conclusions: In addition to its ability to prevent recurrences, prophylactic lithium treatment appears capable of reducing both the ex cess suicide risk and excess cardiovascular mortality of affective ill ness.