Lithium in drinking water and suicide mortality: Interplay with lithium prescriptions

Abstract

BackgroundLittle is known about the effects of lithium intake through drinking water on suicide. This intake originates either from natural rock and soil elution and/or accumulation of lithium-based pharmaceuticals in ground water.AimsTo examine the interplay between natural lithium in drinking water, prescribed lithium-based pharmaceuticals and suicide in Austria.MethodSpatial Bayesian regressions for males, females and pooled suicide mortality rates were estimated.ResultsAlthough the expected inverse association between lithium levels in drinking water and suicide mortality was confirmed for males and for total suicide rates, the relationship for females was not significant. The models do not indicate that lithium from prescriptions, assumed to accumulate in drinking water, is related to suicide risk patterns either as an individual effect or as a moderator of lithium levels in drinking water. Gender-specific differences in risk factors and local risk hot spots are confirmed.ConclusionsThe findings do not support the hypotheses that lithium prescriptions have measureable protective effects on suicide or that they interact with lithium in drinking water.

Antisuicidal Effects in Mood Disorders: Are They Unique to Lithium?

“…Finally, for lithium, we carried out a systematic search and summarized findings of a growing number of studies that evaluated associations of the low concentrations of lithium in local drinking water with reported suicide or homicide rates in the same communities or regions. We found 18 such reports [53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70]. Several of these reports involved an apparently single set of data from Austria, and their findings are pooled [57][58][59]62].…”

Lithium in Public Drinking Water and Suicide Mortality in Portugal: Initial Approach

“…Suicide is one of the largest health burdens in industrialized nations. 1 Traditionally, Portugal is touted as a country with low standardized suicide rates, alongside other coun-tries in Southern Europe, where rates have also been declining -currently at around 7.5 per 100 000 inhabitants, in contrast to an European average of 10 per 100 000. 2 Suicide is considered a multifactorial event caused by a complex interaction between biological, genetic, psychological, social and environmental factors.…”

“…3 The complexity of epidemiology of suicide is amplified by considerable risk variations between nations and within countries. 1 Several studies from developing and industrialized countries indicate a prevalence of mental disorders in about 90% of cases of suicide; in particular, individuals with a mood disorder have a suicide risk 10 to 20 times higher than the general population. 3 Several meta-analyses of clinical trials have found that suicide risk among those with mood disorders is significantly reduced when they are treated with lithium.…”

Lithium for long-term treatment of unipolar depression

“…Of the many potential effects of environmental lithium on brain and behaviour, a reduction in suicide prevalence at a population level is the most consistently found, an effect that appears to be independent of lithium prescriptions. 10 The findings of Tiihonen and colleagues from their Finnish National data should be replicated; more randomised trials of lithium monotherapy in unipolar depression should be conducted and, if the benefits are verified, practice should reflect this. Finally, all aspects of lithium and its effects on the brain and behaviour should be the focus of continuing rigorous scientific enquiry.…”