MIRECC / CoE

VISN 1 MIRECC Staff: Eric G. Smith, M.D., Ph.D., MPH Bio

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Eric G. Smith, M.D., Ph.D., MPH 

Dr. Smith is a VA Psychiatrist working as a VA Mental Health Services and Suicide Prevention Researcher since 2007. He has an MD from Duke Medical School, a PhD in Clinical and Population Health from UMass Medical School and an MPH in Epidemiology and Biostatistics from Boston University. Dr. Smith completed an HSR&D Career Development Award (CDA) examining the association between lithium prescriptions and suicide risk. That project applied sophisticated propensity score methods to VA’s extremely rich clinical databases and concluded that receiving lithium was not associated with a reduction in suicide risk over the first year of treatment, potentially because the data suggested that patients who stopped lithium treatment in the first year transiently were at increased risk of suicide. Similar findings of a lack of significant benefit for lithium (added to usual care) in preventing suicide-related events were reported in 2021 from the VA’s large Collaborative Studies Program randomized trial that involved Dr. Smith and many other VA researchers. However, Dr. Smith’s CDA analyses data did suggest that patients receiving lithium may be at reduced risk of all-cause mortality in the first year of treatment. Furthermore, Dr. Smith’s team recently published indicating that patients with nonbipolar disorder conditions (e.g., major depression and psychotic disorders) receiving lithium experienced a significant reduction in the risk of suicide death in one of the two primary analyses. Dr. Smith has also examined charts of Veterans dying of suicide to determine how care could be improved and has investigated innovative approaches to assessing risk of suicidal ideation or behavior in Veteran inpatients during hospitalization and post-discharge (including implicit association testing). Dr. Smith is currently examining the safety of lithium and clozapine, since both medications that have been previously reported in some non-VA studies to be associated with reduced suicide behavior risk.

Education

• B.A., Biology, John Hopkins University, 1985
• M.A., Botany / Plant Molecular Biology, UC Berkeley, 1988
• M.J., Journalism, UC Berkeley, 1990
• M.D., Medicine, Duke School of Medicine, 2000
• MPH, Epidemiology and Biostatistics, Boston University School of Public Health 2004
• Ph.D., Clinical and Population Health Research, University of Massachusetts Medical School 2014

Areas of Research Interest

• Suicide Prevention
• Mood Disorders
• Quality of Life
• Medication Persistence
• Comparative Effectiveness Research

Projects & Grants

• Identifying Safe Stimulant Prescribing Practices to Protect Patients, Inform Key Program Initiatives, and Assist Providers (PI)
  This study works with Program Partners to investigate the safer use of prescribed stimulants, a medication class whose use has skyrocketed in recent years. 2023-2025.
• Identifying Best Practices for Medication-Based Suicide Prevention Strategies to Minimize the Risk of Medically-Serious Adverse Events (PI)
  The goal of this study is to facilitate the safer use of Lithium and Clozapine, two medications with suicide prevention potential, through evaluating the risk of serious medical side effects associated with these medications. 2020-2023.
• The AIM Study: Investigating Whether Actigraphy and Ideation Measures Can Promote Patient Safety (PI)
  This study used data on suicide risk factors from VHA data combined with novel approaches (actigraphy and implicit association testing), rating scale, and personal history data from Veterans with current or recent suicidal thinking or behavior to determine how well inpatient suicidal ideation and post-discharge suicidal behavior risk can be predicted. 2017-2021.
• Enhancing Lithium's use in the VA through the design, initial implementation, and assessment of the Lithium Support System (the ELeVAte Study) (PI)
  This pilot study developed a “Lithium Support System” using near real-time CDW data to track and notify prescribers of both of upcoming monitoring intervals and of the occurrence of clinical events that are powerful risk factors for Li toxicity episodes such as interacting medications from non-psychiatric providers, certain medical illnesses, and excessive dosing. 2019.
• Assessing Medications as Interventions to Prevent Suicide in the VHA (PI)
  This study used the high-dimensional propensity score technique to examine lithium’s association with suicide deaths and all-cause mortality. 2011-2015.

Dr. Smith's Complete Published Work