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Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
Published on: January 7, 2019
Emerging pharmacological and neuromodulation interventions for suicidal ideation and behaviour
Mauro Scala1, Enrico Magrini2, Ivana Leccisotti3
1Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Campus de Villaviciosa, Calle Tajo s/n, 28670, Villaviciosa de Odón, Madrid, Spain; School of Medicine, Complutense University of Madrid, Madrid, Spain; Health Research Institute Hospital 12 de Octubre, (imas12), Madrid, Spain.
Summary
New research explores non-FDA-approved treatments for suicidal ideation (SI) and suicide attempts (SA). Pharmacological and neuromodulation interventions show promise for rapid SI reduction, independent of mood changes.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Suicide is a major global health concern with limited treatment options.
- Current treatments for suicidal ideation (SI) and suicide attempts (SA) often have delayed effects, poor durability, or tolerability issues.
Purpose of the Study:
- To review recent evidence on non-approved pharmacological and neuromodulation interventions for SI/SA.
- To assess the efficacy and effectiveness of these interventions.
Main Methods:
- A structured literature search of PubMed for studies on adults with SI/SA.
- Inclusion of controlled trials and observational/naturalistic studies.
- Analysis of 34 studies: 22 pharmacological and 12 neuromodulation.
Main Results:
- Pharmacological agents like NRX-101, d-cycloserine, buprenorphine, and ayahuasca showed encouraging results for SI reduction.
- Neuromodulation techniques including TMS, theta-burst stimulation, and magnetic seizure therapy demonstrated efficacy.
- Observational data linked certain medications (e.g., folic acid, testosterone) and non-vitamin K oral anticoagulants with reduced suicidality, while cannabis use was associated with worse outcomes.
Conclusions:
- Pharmacological and neuromodulation interventions offer potential for rapid reduction of suicidal ideation.
- Evidence suggests some treatments may act independently of mood changes, but more research is needed.
- Future studies should focus on suicide-specific outcomes, durability, and high-risk periods.
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