Methods and means of medical prevention of suicide

Despite the fact that suicides are potentially preventable, the prevention of suicides, the death rate from which is comparable to that from bacterial epidemics, remains an urgent global problem. The WHO describes suicide as "an act of deliberate killing" that is at the extreme end of a continuum of suicidal behavior. The purpose of the study is to systematize information about the methods and means of drug prevention of suicides. Results. The issues of suicide prevention are considered. The authors came to the conclusion that it is necessary to identify predictors of suicidal behavior and form homogeneous population groups: 1 ) mentally ill (subgroups - in the DSM-V definitions); 2) relatively healthy people (those who do not experience social and economic disadvantage, clinically pronounced health disorders and who cannot be qualified in the DSM-V definitions) - who have a high risk of committing suicide in the future, as having a constant pattern of predictors of suicidal behavior. Such a classification will make it possible to create a register of persons prone to suicide and to carry out planned population and clinical prevention of suicide in target groups. Methods of restricting access to lethal means and objects, programs to raise awareness about the problem of suicides in schools are considered as means of suicide prevention. The issues of using pharmacological agents with a proven anti-suicidal effect, such as cholecalciferols, ketamine, clozapine, lithium salts, long-acting intravenous antipsychotics, and electroconvulsive therapy, are analyzed in particular detail. Based on rational information about the biological activity of the listed pharmacology agents, it follows that schizophrenic and depressive personality disorders are comorbid with suicidality, but are not pathogenetically associated with suicidality. It is concluded that for active and effective suicide prevention it is necessary: 1) to classify potential suicides into homogeneous groups; 2) to create a controlling structure, including using digital computing tools in order to create a register of persons potentially capable of committing suicide. In particular, such a tool can be artificial intelligence technologies and big data analysis for prompt tracking of trigger requests on the Internet and using mobile communications.