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.