Military Developing Anti-Suicide Nasal Spray As Deaths Hit Record Numbers

By Katie Drummond, The Daily

20 August 12

s the suicide rate among soldiers climbs to the highest levels in history, the Army is hoping Americans might one day treat their mental health woes with a single sniff.

The Army has just handed a $3 million grant to researchers at the University of Indiana's School of Medicine for the creation of an anti-suicide nasal spray. The project, to be led by Dr. Michael Kubek, an associate professor of neurobiology, is arguably one of the more unusual military efforts to thwart a record number of suicides among active-duty personnel and veterans.

"Suicide is the toughest enemy I have faced in my 37 years in the Army," Gen. Lloyd J. Austin III, the Army's vice chief of staff, said this week in announcing new suicide numbers. Austin is spearheading his service's efforts to find ways to halt the surge in suicides.

"That said, I do believe suicide is preventable," Austin added. "To combat it effectively will require sophisticated solutions aimed at helping individuals to build resiliency and strengthen their life coping skills."

According to Kubek and his colleagues, a snort of their suicide-stopping neurochemical - a naturally occurring compound called thyrotropin-releasing hormone, or TRH - could be the solution.

Suicide among American troops has increased steadily since the start of the wars in Iraq and Afghanistan. In July, the number of suicides among active-duty soldiers reached 26 - more than double the number in June and the highest for any month since the Army began keeping such statistics.

The Pentagon reported in June that suicides among soldiers have averaged one per day this year, an 18 percent increase in suicides during the same period last year, and have now surpassed the rate of combat fatalities.

"We've known since the 1970s that TRH has antidepressant effects, and it works quite rapidly," Kubek, whose work has been instrumental in uncovering how TRH impacts the brain, told The Daily. "The bottom-line problem has been figuring out how to get it into the brain."

Earlier trials of TRH already showed that boosting an individual's levels can quickly decrease suicidal ideas, depression and bipolar disorders. But doctors have until now relied on spinal taps to dose patients - because TRH can't cross the blood-brain barrier by more traditional methods, like pills or injections.

By harnessing new advancements in nanotechnology, however, Kubek's research team has now devised nanoparticle drug-delivery systems, designed to dissolve over time inside the brain, that can safely usher TRH across the blood-brain barrier when inserted into the human nasal cavity.

The nanoparticle breakthrough was enough to convince military brass that Kubek's nasal spray just might have a shot at preventing suicides. The project's three-year Army grant will be used to ascertain whether TRH and the drug-delivery systems are safe, and then conduct a clinical trial to "show, in human patients, that this really can save lives," Kubek said.

And like a myriad of military medical breakthroughs before it, the spray might one day make it into the hands, and noses, of civilian patients. Already, the National Institute of Mental Health has funded research that used TRH to treat civilians suffering from bipolar disorder and depression. "This is far from a soldiers-only solution," Kubek said. "Potentially, if this works, we have an entirely new type of pharmacology."

Indeed, experts in the realm of civilian mental health said they're heartened by the research. "This is a brilliant idea," Dr. Ken Duckworth, medical director for the National Alliance on Mental Illness, told The Daily. "It would solve one of the biggest problems we have with medication used today. It might work, but it doesn't work fast enough."

Should the program succeed, TRH wouldn't entirely replace traditional antidepressants. Instead, Kubek envisions using it as a rapid-fire prevention tactic among patients in crisis, or immediately after a patient starts taking antidepressants, such as Prozac or Zoloft, which typically take four to six weeks to kick in.

"The phase directly after starting an antidepressant is very vulnerable time frame in a patient's life," he said, adding that patients aged 18-24, like much of the military population, are most at-risk during this period. "The nasal spray would stabilize them right away, while they wait for the [antidepressants] to do their job."

Nationwide, suicides are the 10th leading cause of death among adults, according to the Centers for Disease Control and Prevention, and rates continue to hold steady or increase across demographics. "As a public health concern, suicide is something we haven't had success in addressing," Duckworth said. "There is a crying need out there for something like this."