Suicidal Ideation Clinical Trial
Official title:
Ovarian Hormone Withdrawal and Suicide Risk: An Experimental Approach
This within-person, crossover, 2-condition, placebo-controlled study compares the impact of two perimenstrual conditions on severity of suicidal symptoms in females with past-month suicidality but minimal risk of imminent suicide attempt. The two conditions are (1) natural perimenstrual withdrawal from estradiol and progesterone (during placebo), (2) perimenstrual stabilization of estradiol and progesterone using transdermal estradiol and oral micronized progesterone.
A large number of observational studies have documented increased risk of suicide attempt,
suicide death, and more lethal attempts during the perimenstrual (around menses) window of
the female reproductive cycle; however, no experiments have investigated the causal role of
ovarian steroid changes across the natural perimenstrual period in risk factors for acute
suicidality. In response, the proposed experimental work investigates a causal role of
perimenstrual withdrawal from the hormones estradiol (E2) and progesterone (P4) in
previously-documented acute perimenstrual increases in suicidality.
Participants are 30 women between the ages of 18 and 45 with current suicidal ideation but
minimal risk for suicide attempt. Using a placebo-controlled, crossover within-person design,
the experiment tests the hypothesis that suicidality will be heightened during natural
perimenstrual E2/P4 withdrawal (under placebo), but that experimental prevention of this
perimenstrual E2/P4 withdrawal (with exogenous administration of E2/P4 hormones) will prevent
these perimenstrual increases in suicidality and associated risk factors.
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