Intermittent Theta-Burst Stimulation with D-Cycloserine: A New Hope for Suicidal Ideation
Background
Depressive disorders are common among people who die by suicide. Intermittent theta-burst stimulation (iTBS) is a noninvasive treatment for those struggling with hard-to-treat depression and at risk for suicide. Combining iTBS with D-cycloserine, a medication that enhances antidepressant effects, may offer better outcomes. However, its effects on suicide risk were previously unknown.
What We Did
We investigated the impact of iTBS combined with D-cycloserine on suicidal thoughts and implicit suicide risk in two clinical trials:
- An open-label trial with 12 participants.
- A randomized placebo-controlled trial with 50 participants.
Additionally, we assessed the effects of D-cycloserine alone on implicit suicide risk in a crossover trial with 18 participants. We measured implicit suicide risk using a computerized test and evaluated depressive symptoms and suicidal thoughts with a clinical rating scale.
Key Findings
- Participants receiving iTBS combined with D-cycloserine experienced a rapid reduction in suicidal thoughts.
- This combination was more effective in reducing suicidal ideation compared to iTBS with a placebo.
- There was also a significant decrease in implicit suicide risk using the death/suicide test.
- D-cycloserine alone did not impact implicit suicide risk.
Conclusion
Combining D-cycloserine with iTBS appears to be an effective strategy for reducing suicidal thoughts and implicit suicide risk in patients with depression.
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