Pharmacological Strategies for Suicide Prevention Based on the Social Pain Model: A Scoping Review

Suicidal behavior is a growing public health problem. Existing treatments have limited efficacy for people who have already attempted suicide, so new approaches are needed. Research on the neurobiology of social pain—a risk factor for suicide—has identified promising pharmacological targets. This paper reviews and critically evaluates evidence for these targets, examining how social pain relates to the anti-suicidal properties of recently approved treatments like ketamine and psilocybin. These strategies may reduce suicidal ideation and behavior in the short term, especially when social pain is a contributing factor, and may work regardless of psychiatric diagnosis, though careful evaluation is required.

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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 a 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 strategies that could reduce suicidality in patients with suicidal ideation or a recent attempt. In this paper, the 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 examined. Such strategies may be effective for the short-term reduction in suicidal ideation and behaviour, 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, but they require careful evaluation.