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ContextSeveral studies have suggested that lithium treatment reduces risk of suicide in bipolar disorder, but no research has examined suicide risk during treatment with divalproex, the most commonly prescribed mood-stabilizing drug in the United States.ObjectiveTo compare risk of suicide attempt and suicide death during treatment with lithium with that during treatment with divalproex.Design and SettingRetrospective cohort study conducted at 2 large integrated health plans in California and Washington.PatientsPopulation-based sample of 20 638 health plan members aged 14 years or older who had at least 1 outpatient diagnosis of bipolar disorder and at least 1 filled prescription for lithium, divalproex, or carbamazepine between January 1, 1994, and December 31, 2001. Follow-up for each individual began with first qualifying prescription and ended with death, disenrollment from the health plan, or end of the …