Table 1 In-and exclusion criteria

- Male and female patients at least 18 years of age and older

- Presenting with a depressive episode (MDE, uni/bipolar), moderate to severe according to DSM IV criteria

- Admitted as an inpatient

- Suicidal thoughts and/or behavior defined by a score ≥ 8 in the S-STS scale and a score ≥ 20 in the MADRS Scale at time of screening and baseline

- Written informed consent

- Pre-treatment with lithium within the last six months before inclusion in the study

- Patients after compulsory hospitalization or patients unable to understand the study protocol

- Diagnosis of antisocial and/or Borderline personality disorder, alcohol and drug dependency (positive drug screening)

- Contraindication following drug approval such as severe heart failure (arrhythmias), severe renal dysfunction, Addison’s disease and others

- History of hypersensitivity towards components of trial medication

- Pregnant or lactating women, women attempting to get pregnant, and women not practicing a reliable method of contraception