An Update on Somatic Treatments for Suicide Risk.
The American journal of psychiatry June 1, 2026 Mina M Rizk, J John Mann 1 citation
Lithium and clozapine are associated with reductions in suicidal behavior in bipolar disorder and schizophrenia spectrum disorders, respectively, through mechanisms beyond disease stabilization. Intravenous ketamine rapidly reduces suicidal ideation in randomized controlled trials, partially independent of antidepressant effects, though the benefit is generally transient and studies were not powered for suicidal behavior. Antidepressants reduce suicidal ideation primarily through improvement in depressive symptoms, and observational studies generally find reduced suicidal behavior risk. Electroconvulsive therapy rapidly reduces suicidal ideation and suicide mortality, while transcranial magnetic stimulation appears to reduce suicidal ideation primarily via antidepressant effects. Targeting the diathesis for suicidal behavior is a largely unexplored therapeutic strategy.