Predicting suicide ideation is a critical precursor to providing intervention and treatment to at-risk individuals. In patients who suffer from depression and other disorders that impact mood, antidepressants are often the standard method of treatment.

Antidepressants have the potential to make matters worse, however. In 2004, the U.S. Food and Drug Administration (FDA), prompted a Black Box Warning on selective serotonin reuptake inhibitors (SSRIs) that acknowledges the risks of suicidal thoughts in children, teens, and young adults.

Patients who are treated with antidepressants should be regularly screened for suicide ideation through follow-ups. The results of recent research conclude that prediction may be possible.

Identifying treatment-worsening suicide ideation

Doctors may soon be able to identify suicide ideation in patients receiving antidepressant treatment, according to a study in the Journal of Clinal Psychiatry.

The study analyzed data collected from 2007-2011 involving 237 patients ages 18-75 with major depressive disorder (MDD). Patients in the study received either 60 mg of duloxetine (an antidepressant drug) or placebo.

Researchers examined the link between treatment-worsening suicide ideation (TWSI) and clinical and biological factors.

TWSI involved a 1-point increase on the Montgomery-Asberg Despression Rating Scale (MADRS) item 10, which identifies suicidal thoughts.

The MADRS is a ten-item questionnaire used by psychiatrists to evaluate a patient’s level of depression. For example, zero points indicate that a patient is happy, whereas six points indicate that a patient is at risk of dying by suicide.

Researchers zeroed in on item 10 over the course of eight weeks while assessing suicide ideation. They then assessed overall depression severity by adding up total scores from all items found in the MADRS. In addition, they assessed anxiety severity by using the Hamilton Anxiety Rating Scale and a familial psychiatric history questionnaire.

When assessing from baseline, researchers used blood samples to analyze a link between or overlap of messenger RNA (mRNA) and microRNA (miRNA) – both of which are genetic codes transcribed in patients’ DNA. They were then able to create TWSI predictive models based on clinical factors, mRNA, miRNA, and combined factors.

Nearly 10 percent of patients who received duloxetine exhibited TWSI at baseline analysis, however, TWSI was not predicted in patients who received a placebo.

Urging healthcare providers to do the right thing

Signs of depression and suicide ideation aren’t always clearly exhibited. The stigma placed on individuals who are at risk of dying by suicide has enabled a culture where individuals may go to great lengths to mask their suffering. Thus, identifying suicide ideation, and even depression, may be impossible in some cases. The signs may only become apparent after a person has attempted suicide or lost his or her life.

As researchers continue to identify prediction methods, our medical system is inching closer to effective solutions that could save lives. It’s critical that doctors and other medical professionals are properly trained to identify suicide risks and proceed with proper intervention measures.

The Law Offices of Skip Simpson has been closely watching emerging medical developments and we urge hospitals and doctors to do the right thing. If you have lost a loved one to suicide because of someone else’s failure to provide intervention, contact us online to discuss your matter. We’re dedicated to representing families of mental health patients and holding negligent parties accountable.

People suffering from post-traumatic stress disorder (PTSD) are at a heightened risk of suicide.

According to an article by Live Science, researchers have found a link between suicidal thoughts and certain receptors on the surface of the brain cells of someone suffering from PTSD, in contrast with people without PTSD.

People with PTSD often suffer from severe anxiety, flashbacks, and uncontrollable thoughts surrounding a traumatic event. It’s primarily caused by any event that causes severe fear and stress and is most common in military combat veterans. The most common symptoms of PTSD, according to Live Science, include:

• Re-experiencing: This includes flashbacks, reliving certain events, nightmares, frightening thoughts, sweating and increased heart rate. Re-experiencing can be triggered at any time when a person with PTSD sees or hears something that brings back memories of an event.
• Avoidance: People with PTSD will often avoid bringing up certain things that remind them of a certain event. They may also avoid certain places, events, or situations that may put them at risk of experiencing flashbacks and uncontrollable thoughts and actions.
• Hyperarousal: People with PTSD may be easily startled, experience chronic stress, and the feeling of being “on edge.” Unlike re-experiencing, this symptom isn’t triggered, but rather constant.

Study findings

The study was recently published in Proceedings of the National Academy of Sciences (PNAS), a peer-reviewed multidisciplinary scientific journal. It found that the brain receptor called metabotropic glutamatergic (mGluR5) found in people with PTSD may be further examined for the development of future PTSD drug treatment. Metabotropic glutamatergic plays a functional role in several brain processes, including learning and memory, sleep, and cognitive functioning.

There are currently only two drugs approved by the Food and Drug Administration (FDA) used for treating patients with PTSD. These drugs were initially designed to treat depression and aren’t effective for everyone with PTSD, however. Moreover, patients with PTSD often don’t benefit from the drug for weeks or months.

In the study, researchers scanned the brains of 29 PTSD patients, 29 people who suffered from depression (but didn’t have PTSD), and 29 people who had no diagnosed psychiatric disorder. Participants were asked if they had experienced any suicidal thoughts on the day of the scan. Those who had active suicidal thoughts with actual intent were excluded from the study and given immediate medical help. Those who had more passive suicidal thoughts without any intent were included in the study.

In comparison with healthy individuals without psychiatric disorder, participants with PTSD had higher levels of mGluR5 on the surface of the brain cells in five regions of the brain. Moreover, researchers found a link between the presence of mGluR5 only in people with PTSD, but not in people with depression.

Researchers are hopeful that the information found in this study will lead to effective suicide prevention for people with PTSD. Currently, drugs that directly target mGluR5 exist, but they have yet to be tested for PTSD treatment. Prior studies suggest that such drugs could cause an increase in anxiety among people with PTSD.

These study findings are a positive step for suicide prevention. The Law Offices of Skip Simpson will continue to keep an eye on these developments. We represent the families of those who have died by suicide across the United States. If you lost a loved one to death by suicide, contact us only to discuss your matter and explore your legal options.