Richard Shelton, M.D., University of Alabama at Birmingham
Standard Research Grant (2009): $75,000
Paliperidone and Lithium in the Treatment of Suicidality-Treatment Indication and Epigenetic Regulation
Abstract: This study aims to identify an efficient pharmacotherapy for the acute management of suicide and the epigenetic regulation associated with the treatment to prevent suicide and depression. The primary objective of this study is a 12-week clinical trial to compare the efficacies of the antipsychotic paliperidone and the mood stabilizer lithium in the acute management of suicidal behaviors and actions in patients with depression. In this study, subjects with major depressive disorder, currently experiencing severe depression with suicidal behavior and actions, will be treated with a selective serotonin reuptake inhibitor antidepressant in addition to being randomized to paliperidone, lithium, or placebo. The secondary but equally important objective of this study is to begin to test the epigenetic regulation of paliperidone and lithium during treatment of suicide. This study will directly contribute to suicide prevention as an immediate clinical need as well as development of a new treatment along with an understanding of epigenetic mechanism, a newly recognized molecular mechanism (DNA methylation), that exerts lasting control over gene expression and mediates stable adaptation of behaviors involved in these behaviors.