Clinical and Imaging Trial of Uridine for Veterans With Suicidal Ideation

Veteran suicides, attempts and suicidal ideation (SI) remain an urgent concern for the Veterans Health Administration (VHA). Research indicates that approximately half of veteran suicides take place within 1 month of the decedent's final VHA encounter, with one quarter occurring within 1 week. This provides a temporal window of opportunity to intervene, and necessitates development of a rapid-acting treatment for veterans with SI. Uridine shares similar brain mechanisms and neural effects with ketamine and lithium, treatments commonly used to reduce suicidal ideation. This study will test the novel intervention uridine as a rapid-acting oral treatment for veterans with suicidal ideation. The purpose of this study is to investigate whether uridine can decrease suicidal ideation in veterans when taken daily for 4 weeks.

In addition to treatment with the investigational drug versus placebo, the study includes a translational neuroimaging component: magnetic resonance spectroscopy (1H-MRS) brain scans are performed at baseline, and then repeated following 1 week of treatment with uridine or placebo. The scans do not use radiation, and are performed on a 3 Tesla MRI system that is approved for clinical use. The scans allow researchers to measure the concentrations of several chemicals in the brain that are may be involved in suicidal ideation.

Inclusion criteria

• Must be able to Provide Informed Consent.
• Must be a Veteran of the U.S. Armed Forces.
• Columbia-Suicide Severity Rating Scale Indicates Current Suicidal Ideation
• Beck Scale for Suicide Ideation Score > 3 (i.e. "Greater Than or Equal to 4").
• History of > 1 Suicide Attempt or Hospitalization to Prevent Suicide in Past 12 Months; or Functionally Impairing Suicidal Ideation Not Due to a DSM Axis II Diagnosis, in the Past 12 Months.
• Females and Males Ages 18-55 Inclusive.
• Willing and Able to Identify an Alternative Contact Person, e.g. Family Member, Friend or Neighbor.

Exclusion criteria

• Schizophrenia or Other Psychotic Disorder.
• Active Substance Use Disorder Requiring Stabilization (N.B. Does Not Include Nicotine).
• Unstable Medical Condition(s).
• Pregnancy or Breastfeeding.
• Contraindication to MRI (e.g. Ferrometallic Implant or Claustrophobic Anxiety).
• Concurrent Enrollment in Another Clinical Trial.
• Significant Risk of Protocol Non-Adherence (e.g. resides > 50 miles from the hospital, and has no automobile or alternate transportation).