Suicidality: prevention, detection and intervention

Anderson, Jean; Mitchell, Philip B.; Brodaty, Henry

doi:10.18773/austprescr.2017.058

Cited by 7 publications

(24 citation statements)

References 25 publications

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“…Moreover, GAL(1-15) combined with SSRIs could improve their effectiveness in treating depression symptoms. Thus, we observed in rats that GAL (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) enhanced the antidepressant effects induced by fluoxetine in tests related to despair and anhedonic behaviour. This GAL(1-15) effect was also observed in an olfactory bulbectomized rat (OBX) model of depression [27,28].…”

Section: Introductionmentioning

confidence: 85%

“…We have described that the neuropeptide Galanin (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) [GAL (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)] induces strong depression and anxiogenic-like effects [22,23] and also a strong anhedonia-like phenotype, a key symptom of depression [24], acting through GALR1-GALR2 heteroreceptor complexes in the CNS [23,25]. However, GAL (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) is able to enhance the antidepressant effects induced by the 5-HT1AR agonist 8...…”

Section: Introductionmentioning

confidence: 99%

“…In the current study, we analyzed the effect of GAL(1-15) on ESC-mediated effects in alcohol consumption using the alcohol self-administration test, a widely accepted approach to assess reward-seeking behaviours. Additionally, to study if the combination GAL (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and ESC modulate the reward system induced by reinforcers different from alcohol, we analyzed this combination in two other rewarding tests: the sucrose preference test (SPT) and the saccharine self-administration test. Moreover, in animals under chronic alcohol intake by self-administration, we studied whether GAL(1-15) + ESC combination modulated the response in behavioural tests related to despair (FST and TST) or anxiety (open field test and elevated plus-maze).…”

Section: Introductionmentioning

confidence: 99%

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The Combination of Galanin (1–15) and Escitalopram in Rats Suggests a New Strategy for Alcohol Use Disorder Comorbidity with Depression

et al. 2022

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Alcohol use disorder (AUD) is highly prevalent, and over 50% of AUD patients also suffer major depressive disorders. Selective 5–HT reuptake inhibitors (SSRIs) can reduce rodent ethanol drinking but exert modest clinical efficacy in alcoholic individuals. Finding new pharmacological strategies that could modulate alcohol consumption and depression is necessary. We have analyzed the effect of Galanin(1–15) [GAL(1–15)] on escitalopram (ESC)–mediated effect in alcohol consumption using the alcohol self–administration test, the nuclei involved in the effect, and whether GAL(1–15 + ESC modulated the response in despair or anxiety tests in animals under chronic alcohol intake. GAL(1–15) + ESC combination substantially reduced alcohol intake in the alcohol self–administration test and, moreover, enhanced the reduction of reward capacity of ESC on different reinforcers such as sucrose or saccharine. GAL(1–15) + ESC coadministration significantly decreases the number of c–Fos–IR TH cell bodies in the VTA, and PCA analysis suggests that one functional network, including VTA, RMTg and DR, is involved in these effects. Significantly in rats with chronic alcohol consumption, GAL(1–15) reversed adverse ESC–mediated effects in the depression–related behavioural test and forced swimming test. The results open up the possibility of using GAL(1–15) in combination with the SSRI Escitalopram as a novel strategy in AUD comorbidity with depression.

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Section: Introductionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Combination of Galanin (1–15) and Escitalopram in Rats Suggests a New Strategy for Alcohol Use Disorder Comorbidity with Depression

et al. 2022

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“…Most patients ingested drugs for suicide purposes, similar to studies conducted in Denmark and Australia. [ 11 22 ] The suicidal intention is correlated with an absence of family support, with the severity of the psychosocial problem, and with multidrug abuse, and also with requests for treatment. [ 23 ]…”

Section: Discussionmentioning

confidence: 99%

What are the Predictive Factors for the Treatment Outcomes in Multi Drug Poisoning Including Antidepressants/Antipsychotic Drugs?

et al. 2018

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Background:There have been studies on the outcome of acute intoxication with antidepressants or antipsychotics. We performed outcome prediction analysis in acute poisoning patients with antidepressants/antipsychotics with or without combination with other drugs.Materials and Methods:A cross-sectional study was performed in Khorshid (PBUH) University Hospital affiliated with Isfahan University of Medical Sciences from March 2016 to May 2017. Patients with acute poisoning ingested antidepressants and antipsychotics with or without other drugs were included in the study. The outcome was categorized as survived without complications and complications/death. Binary regression analysis was performed for outcome prediction.Results:The data from 239 patients were analyzed. Most of the patients were female (68.2%), 5.9% of patients admitted to the Intensive Care Unit. About 94.99% of patients survived without complications. There was a significant difference between patients with and without complications with respect to the level of consciousness, hypotension, seizure, electrocardiography findings, pulse rate after 24 hours (h) of admission, and need to endotracheal intubation (P < 0.0001). Binary logistic regression analysis showed admission level of consciousness (stupor/coma) (odds ratio [OR] =8.07; P = 0,005), hypotension (OR = 12.16; P = 0.001), seizure (OR = 11.15; P = 0.009), tachycardia after 24 h of admission (OR = 22.50; P = 0.003), and need for endotracheal intubation (OR = 10.47; P = 0.002) were determinant factors in outcome prediction.Conclusions:Stupor/coma and hypotension were the predictive factors for outcome. Patients with seizure and tachycardia after 24 h of admission; and those intubated and received mechanical ventilation had a higher chance of complications.

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“…Some generalities to draw are combined somatic and psychosocial interventions have better outcomes; addressing modifiable risk factors is mandatory; therapeutic approaches should target (formerly) axis I and II psychiatric disorders, specifically associated symptoms (e.g., depression, agitation, anxiety, insomnia) and predominant psychodynamic or psychosocial stressors. [ 36 ]…”

Section: Psychiatric Managementmentioning

confidence: 99%

Suicide: A Précis!

Naguy

Elbadry

Salem

2020

J Family Med Prim Care

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Background: Suicide remains a psychiatric emergency, tragedy, a public health burden, and for those aged 15-29, is the second leading cause of death globally. Stigma attached to psychiatric disorders and suicide means many people feel unable to seek help. Aim of Work: We highlighted confusing nosology, psychopathology, neurobiological underpinnings, typology, and, risk factor pertinent to suicide. A road-map to the clinical assessment and management of suicide has also been provided. Last, but not least, we tried to dispel the long-held myths about suicide. Methods: EMBASE, Ovid MEDLINE, PubMed, Scopus, Web of Science, and Cochrane Database of Systemic Reviews were searched for all relevant studies up to date of Jan, 2020. Results: Suicide is self-inflicted death with evidence (explicit/implicit) of intention to die. Suicide reflects many disparate determinants release/relief, response-to the disordered thinking, religious, revenge, rebirth, reunification or rational. 5-HT deficiency appears central to the neurobiology of suicide. Durkheim proposed 4 types of suicide (egoistic, altruistic, anomic, fatalistic). Risk factors for suicide entail both static and dynamic factors. Dynamic factors encompass both clinical and situational variables. Shneidman's concepts of perturbation and psychache are very crucial to consider when assessing the risk. Suicide rating scales are only ancillary with the Modified high-risk construct scale balances vectors of suicidality versus survivality. Myths germane to suicide abound that need to be demystified. Psychiatric management capitalizes on determining a setting for treatment and supervision, attending to patient's safety, as well as working to establish a cooperative and collaborative physician-patient relationship. This entails both psychosocial 'package' and somatic treatments and the best outcomes mandate well-keeled combined approaches. Pharmacologic interventions aim chiefly at acute symptomatic relief. Recently, heaps of data accrue speaking to the idea of ground-breaking 'anti-suicidal' agents that might alleviate suicidal ideation (SI) Conclusion: Suicide continues to be a complex public health problem of global calibre. It is variably tied to a myriad of risk factors underscoring likely etiological heterogeneity. That said, suicides can, at least partially, be prevented by restricting access to means of suicide, by training primary care physicians and health workers to identify people at risk as well as to assess and manage respective crises, provide adequate follow-up care and address the way this is portrayed in the media. A host of psychotherapeutic, pharmacological, or neuromodulatory treatments of mental disorders are readily available that can alter this acrimonious trajectory.

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Suicidality: prevention, detection and intervention

Cited by 7 publications

References 25 publications

The Combination of Galanin (1–15) and Escitalopram in Rats Suggests a New Strategy for Alcohol Use Disorder Comorbidity with Depression

The Combination of Galanin (1–15) and Escitalopram in Rats Suggests a New Strategy for Alcohol Use Disorder Comorbidity with Depression

What are the Predictive Factors for the Treatment Outcomes in Multi Drug Poisoning Including Antidepressants/Antipsychotic Drugs?

Suicide: A Précis!

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