Inflammation and treatment strategies for suicidal behavior.
The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry June 1, 2026 Chittaranjan Behera, Srishti Gupta, Richard Shelton et al. 2 citations
Inflammation and immune dysregulation are linked to suicidal behavior. People with suicidal behavior show elevated levels of pro-inflammatory cytokines (interleukin-6, interleukin-1β, tumor necrosis factor-α), C-reactive protein, and chemokines in blood, cerebrospinal fluid, and brain tissue. These markers disrupt the hypothalamic-pituitary-adrenal axis, monoamine systems, and glutamatergic signaling. Inflammatory activation of indoleamine 2,3-dioxygenase shifts tryptophan metabolism toward neurotoxic kynurenine metabolites, reducing serotonin and promoting excitotoxicity, potentially increasing impulsivity and acute suicidal ideation. Several immunomodulatory treatments—including lithium, ketamine, COX-2 inhibitors, cytokine antagonists, and kynurenine-pathway modulators—show promise in reducing inflammation-linked suicidal risk. Precision-based approaches integrating biomarkers, genetics, and clinical profiles may help identify individuals likely to benefit from these therapies.