Suicide Prevention by Lithium - the Lithium Intervention Study (SUPLI)

The purpose of this study is to examine the proposed suicide preventive effects of lithium in a randomized controlled trial within a group of individuals with depressive disorders. The hypothesis being tested is that lithium treatment will significantly reduce the risk for another suicide attempt.

Several studies have shown that there is a significantly increased risk of suicide related mortality in patients with a positive history of suicide attempts. This study is the first prospective, randomized, double-blind, placebo controlled multi-center trial focussing on the proposed suicide preventive effects of lithium in patients with suicidal behavior but not suffering from bipolar disorder or recurrent major depressive disorder. Patients with a recent history of a suicide attempt are treated with lithium or placebo during a 12 month-period. The hypothesis is that lithium treatment will lead to a 50 % reduction of suicidal behavior.

• Suicide
• Depressive Disorders

• Drug: lithium
• Drug: placebo

• Active Comparator: 1
  Lithium treatment
  Intervention: Drug: lithium
• Placebo Comparator: 2
  Placebo treatment
  Intervention: Drug: placebo

• Lauterbach E, Ahrens B, Felber W, Oerlinghausen BM, Kilb B, Bischof G, Heuser I, Werner P, Hawellek B, Maier W, Lewitzka U, Pogarell O, Hegerl U, Bronisch T, Richter K, Niklewski G, Broocks A, Hohagen F. Suicide prevention by lithium SUPLI--challenges of a multi-center prospective study. Arch Suicide Res. 2005;9(1):27-34.
• Muller-Oerlinghausen B, Felber W, Berghofer A, Lauterbach E, Ahrens B. The impact of lithium long-term medication on suicidal behavior and mortality of bipolar patients. Arch Suicide Res. 2005;9(3):307-19. Review.
• Muller-Oerlinghausen B, Berghofer A, Ahrens B. The antisuicidal and mortality-reducing effect of lithium prophylaxis: consequences for guidelines in clinical psychiatry. Can J Psychiatry. 2003 Aug;48(7):433-9. Review.
• Ahrens B, Muller-Oerlinghausen B. Does lithium exert an independent antisuicidal effect? Pharmacopsychiatry. 2001 Jul;34(4):132-6.

Inclusion Criteria:

• suicide attempt within 3 months prior to the first drug administration
• occurrence of suicide attempt within the context of an affective spectrum disorder
• minimum age of 18 years
• ability to complete screening and baseline assessment
• ability to understand and provide informed consent

Exclusion Criteria:

• diagnosis of schizophrenia, borderline personality disorder, substance related disorders
• indication for long-term lithium treatment
• thyroid disease
• pregnancy and lactation

• German Federal Ministry of Education and Research
• Sanofi
• Dresden University of Technology
• University Hospital, Bonn
• Charite University, Berlin, Germany
• University of Erlangen-Nürnberg