Repetitive Transcranial Magnetic Stimulation as Treatment for Acute Suicidality in Adult Patients

Stopped early · Not applicable · Has a placebo group

Conditions studied: Suicidal Ideation

In brief

Suicide was responsible for almost 40,000 deaths in 2011 in America. It is still singularly difficult to predict who is going to commit suicide and how to establish adequate interventions. Growing evidence supports the view that suicide is associated with poor decision making. Suicide is hypothesized to be triggered by stressful situations that create overwhelming psychological pain in an individual who chooses to terminate his/her own life, disregarding all future consequences. We have previously demonstrated rewarding impulsive choice common to both recent suicide attempters and suicidal depressed patients (1). Consistent with these findings, we hypothesize that high frequency repetitive transcranial magnetic stimulation (rTMS) of the left prefrontal cortex will improve impulsive response tendencies as measured by the delay discounting procedure, and this in turn will be associated with a faster resolution of suicidal ideation. To these effects we will be using a randomized control trial of rTMS in adult inpatients at the Psychiatric Research Institute (PRI) hospitalized for acute suicidality. At the conclusion of these studies, we will have tested the value of decision making in the development of suicide ideation and behavior, as well as piloted the use of rTMS in the treatment of these patients.

Key facts

Study ID

NCT02693743

Run by

University of Arkansas

People needed

1

Starts

2017-05-22

Expected to finish

2019-02-28

Last updated by the study team

2021-05-18

Who can join

Age: 18 and older, up to 60. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age 18-60 years, of all races and ethnicities;
• Admitted voluntarily to the adult psychiatric inpatient at PRI;
• Suffering from a current depressive episode
• Reason for hospitalization should be a recent suicide attempt or suicidal ideation
• Current severe suicidal ideation defined by a score >7 on the Beck Scale for Suicidal Ideation
• Ability to read, write and speak English.

You may not qualify if…

• History of dementia, neurovascular or neurodegenerative conditions
• Physical disabilities that prohibit task performance (such as blindness or deafness)
• Choosing to opt out of the research study.
• Additional exclusion criteria for TMS include the following:
• a personal history or 1st degree relative with history of epilepsy;
• a personal history of head injury, aneurysm, stroke, previous cranial neurosurgery, neurological, or migraines;
• recent use of cocaine or alcohol;
• ferromagnetic metal implants in the head or neck, active or inactive implants(including device leads), deep brain stimulators, cochlear implants or vagus nerve stimulators;
• a pacemaker;
• pregnancy (or the possibility of pregnancy);
• Medications that lower seizure threshold (bupropion or tricyclic antidepressants, such as thorazine, clozapine, amitriptyline, amoxapine, Norpramin, Sinequan, Tofranil, Pamelor, Vivactil, or Surmontil). Other antidepressant and antipsychotic medications have been deemed exhibit a relatively low seizurogenic potential (Pisani et al. 2002).
• Patients taking a medication for weight loss and depression called bupropion (Wellbutrin) they will be excluded because it may increase the likelihood of experiencing a seizure.

Where it is running

• University of Arkansas for Medical Sciences — Little Rock, Arkansas, United States

Full record on ClinicalTrials.gov

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