Daridorexant Use in Psychiatric Patients with Suicidal Thoughts

Risk Assessment and Monitoring

• The American Psychiatric Association recommends assessing current suicidal ideation intensity, plans, intent, and access to lethal means in patients with a history of suicidal thoughts before prescribing daridorexant 1, 2
• The assessment of recent suicide attempts, presence of hopelessness, and comorbid psychiatric diagnoses is crucial in determining the risk of suicidal behavior in patients taking daridorexant 2, 3, 4, 5, 6
• The American Academy of Child and Adolescent Psychiatry suggests that a history of suicidal behaviors in biological relatives should be considered when evaluating the risk of suicidal behavior in patients taking daridorexant 1

Concurrent Suicide Prevention Interventions

• The American College of Physicians recommends implementing cognitive behavioral therapy focused on suicide prevention for patients with suicidal behavior in the past 6 months, as it has strong evidence for reducing suicide attempts 2, 3
• The Annals of Internal Medicine suggests considering CBT-based psychotherapy to reduce suicidal ideation in patients with a history of self-directed violence 2, 3
• The American Psychiatric Association recommends ketamine infusion for patients with major depression and active suicidal ideation, as it provides rapid reduction in suicidal thoughts within 24 hours 2, 3, 4, 5
• Lithium maintenance therapy is recommended for reducing suicidal behaviors in patients with unipolar depression or bipolar disorder 4, 5
• Clozapine is recommended for reducing suicide attempts in patients with schizophrenia or schizoaffective disorder who have suicidal ideation or attempt history 2, 3

Monitoring Requirements

• The American Academy of Sleep Medicine recommends reassessing suicidal ideation at each follow-up using validated measures such as the Columbia Suicide Severity Rating Scale Screener or Beck Scale for Suicidal Ideation 2, 3