Fig. 1

Lethal levels of substances present at suicide by self-poisoning among people with or without bipolar disorder. *p ≤ .0001. Any data point with n < 5 has been suppressed due to privacy limits. As such, values for Lithium (BD and Non-BD), Carbamazepine (BD and Non-BD), Valproate (BD and Non-BD) and Any Mood Stabilizer (Non-BD) have been suppressed. Unknown multiple drug/alcohol toxicity includes cases where multiple substances were present but the coroner was unable to specifically identify which substances were responsible for death. No bar was shown for suppressed data (cell size <5). Non-TCA Antidepressants include: SSRIs, SNRIs, NDRIs, MAOIs. Any Antidepressant refers to TCAs or the ‘non-TCA antidepressants’ (i.e. SSRIs, SNRIs, etc.). Total number of lethal substances not available for some cases as toxicology analysis was indeterminate; therefore number of lethal substances unknown for some. In some cases, typically where a number of substances were present in nonlethal levels, the pathologist concluded the cause of death was multiple drug toxicity without specifying which specific substances were responsible. This occurred in n = 21 BD cases and n = 129 non-BD cases. These suicides were included in the overall analysis but without a specific substance as the cause of death