Eradicating Suicide at Its Roots: Preclinical Bases and Clinical Evidence of the Efficacy of Ketamine in the Treatment of Suicidal Behaviors

International Journal of Molecular Sciences

Antonio Ventriglio¹  Massimo Di Giannantonio²  Federica Vellante²  Giovanni Martinotti²  Gianluca Serafini³  Maurizio Pompili⁴  Kim Yong-Ku⁵  Marilde Cavuto⁶  Giampaolo Perna⁷  Marco Di Nicola⁸  Alessandro Carano⁹  Domenico De Berardis^1,10  Alessandro Valchera^1,11  Carmine Tomasetti^1,11  Laura Orsolini^1,11  Michele Fornaro^1,11  Annastasia Fiengo^1,11 

[1] Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy;Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University “G. D’Annunzio”, 66100 Chieti, Italy;Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy;Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, 00118 Rome, Italy;Department of Psychiatry, Korea University College of Medicine, Seoul 08826, Korea;Department of Theory, Analysis and Composition, Music Conservatory “L. Canepa”, 07100 Sassari, Italy;Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, 22032 Como, Italy;Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, 00118 Rome, Italy;NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “Madonna Del Soccorso”, A.S.U.R. 12, 63074 San Benedetto del Tronto, Italy;National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, “G. Mazzini” Hospital, p.zza Italia 1, 64100 Teramo, Italy;Polyedra Research Group, 64100 Teramo, Italy;

关键词: mood disorders;    dopamine;    serotonin;    glutamate;    postsynaptic density;    antipsychotics;    antidepressants;    NMDA;    suicide;    ketamine;    esketamine;   

DOI  :  10.3390/ijms19102888

来源: DOAJ

【 摘 要 】

Despite the continuous advancement in neurosciences as well as in the knowledge of human behaviors pathophysiology, currently suicide represents a puzzling challenge. The World Health Organization (WHO) has established that one million people die by suicide every year, with the impressive daily rate of a suicide every 40 s. The weightiest concern about suicidal behavior is how difficult it is for healthcare professionals to predict. However, recent evidence in genomic studies has pointed out the essential role that genetics could play in influencing person’s suicide risk. Combining genomic and clinical risk assessment approaches, some studies have identified a number of biomarkers for suicidal ideation, which are involved in neural connectivity, neural activity, mood, as well as in immune and inflammatory response, such as the mammalian target of rapamycin (mTOR) signaling. This interesting discovery provides the neurobiological bases for the use of drugs that impact these specific signaling pathways in the treatment of suicidality, such as ketamine. Ketamine, an N-methyl-d-aspartate glutamate (NMDA) antagonist agent, has recently hit the headlines because of its rapid antidepressant and concurrent anti-suicidal action. Here we review the preclinical and clinical evidence that lay the foundations of the efficacy of ketamine in the treatment of suicidal ideation in mood disorders, thereby also approaching the essential question of the understanding of neurobiological processes of suicide and the potential therapeutics.

【 授权许可】

Unknown