AJOB Neuroscience.

Deep Brain Stimulation and Postoperative Suicidality Among Treatment Resistant Depression Patients: Should Eligibility Protocols Exclude Patients with a History of Suicide Attempts and Anger/Impulsivity?

Recently, there has been a surge of interest in using deep brain stimulation (DBS) to treat patients suffering from treatment-resistant depression (TRD). While DBS has been regarded as an efficient and safe treatment for many conditions over the last 20 years, and although DBS research trials involving TRD patients show encouraging evidence of remission, recent DBS TRD follow-up studies have reported significant rates of postoperative suicidal ideation, as well as suicide attempts and deaths. Given the vulnerable nature of TRD patients with respect to suicide, if the postoperative DBS adjustment process contributes to an increased risk of suicidality among them, then there is a pressing need to investigate this problem. Based on current clinical trial follow-up data, does the suicidality risk-versus-remission benefit ratio favor the use of DBS in TRD patients? The purpose of this article is to examine whether adjusting enrollment criteria, such as excluding TRD patients with a history of suicide attempts or anger/impulsivity, could diminish DBS trial research suicidality, given the absence of uniformity in DBS trial eligibility protocols.

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Volume 4, Issue 1
February 2013

Editorial.

Neuroethics at 10, and Counting Judy Illes & Paul Root Wolpe