Did manic-depressive patients who committed suicide receive prophylactic or continuation treatment at the time?

Ninety-two Danish manic-depressive patients with a first psychiatric admission between 1969 and 1983, who committed suicide before 1 July 1986, were considered. Information on any prophylactic or continuation treatment at the time of the suicide was obtained. In 64 of the patients, every precaution seems to have been taken: 28 patients committed suicide during ongoing treatment; 10 while not receiving prophylactic treatment (not indicated); 7 while not in prophylactic treatment because the patients refused or did not tolerate such; and 19 while in prophylactic treatment with antidepressants (10), or lithium (6), or both (3), in usually adequate dosage. In 28 of the patients, suicide might have been obviated. Guidelines for improvement of suicide prevention in manic-depressive illness are presented.