Neurochemical basis of treatment in suicide - forensic implications

R.G. Tauser

Abstract: The understanding of neuroscientific substrates of suicidal behavior is essential for enhancing predictability and development of adequate therapeutical strategies. The goal of brain exploring by means of morphometrics, neurochemistry and recent methods of molecular biology and genetics is to create a map of cerebral neurochemical circuits correlated with self-aggression behavior. From the neurobiological viewpoint amygdala with its connections to the orbitoprefrontal and anterior cingulate cortices is the keystone of behavior. Serotonin is the most intensively studied neurotransmitter because it plays a key role in aggression and impulsivity and serotonergic functions have been demonstrated to bear similar relationships to aggression in animal models and clinical studies on suicide. Antagonists of 5-HT2A receptors and selective serotonin reuptake inhibitors have antiaggressive efficacy on both animal models and clinical trials. Lithium has antisuicidal effects acting directly on orbitoprefrontal and cingulate cortices. Advances in the understanding of the neurobiology of violence will contribute to a rational assessment and treatment of patients with suicidal behavior.
Keywords: suicide, neurotransmitters, serotonin antagonists, selective serotonin reuptake inhibitors, lithium