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Evidence for the 5-HT Hypothesis of Suicide A Review of Post-mortem Studies

Published online by Cambridge University Press:  06 August 2018

J. J. Mann
Affiliation:
Laboratory of Psychopharmacology, Department of Psychiatry, Cornell University Medical College, New York
V. Arango
Affiliation:
Laboratory of Psychopharmacology, Department of Psychiatry, Cornell University Medical College, New York
P. M. Marzuk
Affiliation:
Laboratory of Psychopharmacology, Department of Psychiatry, Cornell University Medical College, New York
S. Theccanat
Affiliation:
Laboratory of Psychopharmacology, Department of Psychiatry, Cornell University Medical College, New York
D. J. Reis
Affiliation:
Division of Neurobiology, Department of Neurology, Cornell University Medical College, New York

Extract

Although suicide was traditionally considered an extreme response to stress, with the most frequent stress being depressive illness, severity of depression does not distinguish those who commit suicide from non-suicide attempters. A biological role involving the serotonergic system, possibly associated with a genetic risk factor, has been postulated. Low levels of 5-HT and 5-HIAA have been found in post-mortem examinations of brain-stem tissues of suicide victims (levels in cortical tissue were generally normal). An increased number of 5-HT2 receptors was found in the pre-frontal cortex of suicide victims, such upregulation having been demonstrated in induced 5-HT deficiency states; 5-HT1A receptors were also increased. Receptor populations may be altered by chronic psychotropic medication; e.g. 5-HT2 downregulation occurs following administration of antidepressants. There is some indication that the adrenergic system may be involved as well, but this will require further study. Antidepressant drugs may be effective in preventing suicide in patients with non-depressive syndromes who exhibit suicidal behaviour.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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