Lithium and Clozapine in Suicide Prevention:Diagnosis-Specific Evidence and Principles for Clinical Practice
10.4306/jknpa.2026.65.1.1
- Author:
Jaehyun KIM
1
;
Ung Gu KANG
Author Information
1. Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Publication Type:REVIEW ARTICLE
- From:Journal of Korean Neuropsychiatric Association
2026;65(1):1-9
- CountryRepublic of Korea
- Language:English
-
Abstract:
Suicide prevention remains one of the most complex and important tasks in psychiatric practice.Lithium and clozapine have long been considered potential anti-suicidal agents, but the strength and scope of their evidence are largely diagnosis-specific. In clinical settings, however, these drugs are occasionally used in broader contexts, including cases where suicidal ideation itself becomes the primary indication. This raises the need to critically examine how pharmacologic interventions should be applied within appropriate diagnostic and therapeutic frameworks. This review synthesizes existing evidence on lithium and clozapine and discusses their roles within the broader landscape of suicide prevention. Suicide is not a unitary symptom but a multifactorial outcome shaped by biological, psychological, and social determinants. Accordingly, pharmacologic treatment should be understood as one component of a multidimensional strategy that integrates psychotherapy, crisis intervention, and social support systems. From an interpretive standpoint, this review highlights the importance of aligning medication use with established evidence while maintaining clinical flexibility and individualized care. The goal was not to depreciate the therapeutic value of lithium or clozapine but to contextualize their use within a rational, diagnosis-informed, and ethically grounded framework. This paper contributes to a more nuanced and evidence-based model of suicide prevention in psychiatric practice by reinforcing such an integrative approach.
