Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Pharmacotherapy for the Secondary Prevention of Suicide: Leads from the Social Pain Hypothesis

Version 1 : Received: 1 July 2022 / Approved: 5 July 2022 / Online: 5 July 2022 (07:43:48 CEST)

A peer-reviewed article of this Preprint also exists.

Rajkumar, R.P. Pharmacological Strategies for Suicide Prevention Based on the Social Pain Model: A Scoping Review. Psych 2022, 4, 494-515. Rajkumar, R.P. Pharmacological Strategies for Suicide Prevention Based on the Social Pain Model: A Scoping Review. Psych 2022, 4, 494-515.

Abstract

Suicidal behaviour is a public health problem whose magnitude is both substantial and increasing. Since many individuals seek medical treatment following a suicide attempt, strategies aimed at reducing further attempts in this population are a valid and feasible secondary prevention approach. An evaluation of the available evidence suggests that existing treatment approaches have limited efficacy in this setting, highlighting the need for innovative approaches to suicide prevention. Existing research on the neurobiology of social pain has highlighted the importance of this phenomenon as a risk factor for suicide, and has also yielded several attractive targets for pharmacological preventive strategies. In this paper, the available evidence related to these targets is synthesized and critically evaluated. The way in which social pain is related to the “anti-suicidal” properties of recently approved treatments, such as ketamine and psilocybin, is also examined. Such strategies may be effective for the short-term reduction of suicidal ideation and behaviour in individuals who have made a suicide attempt suicide prevention, particularly in cases where social pain is identified as a contributory factor. These pharmacological approaches may be effective regardless of the presence or absence of a specific psychiatric diagnosis.

Keywords

suicide; social pain; psychache; endogenous opioid system; oxytocin; serotonin; endocannabinoids; buprenorphine; psilocybin; ketamine

Subject

Medicine and Pharmacology, Psychiatry and Mental Health

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