Prialt (ziconotide), a painkiller that contains a synthetic version of a toxin extracted from marine snails, is suspected to have a causal relationship to increased suicidal ideation.
In an issue of the medical journal Pain, European researchers reported that two recent cases “substantiate the suspicion of a causal relationship between ziconotide and suicidality.”
Prialt has been FDA approved in the United States since 2004, and although its product labeling contains a black box warning for certain neurological and psychiatric side effects – including cognitive impairment, hallucinations, and changes in mood – it contains no mention of the possibility of increased suicidality or suicidal ideation.
Prialt is considered to be a safe alternative to other painkillers in patients who show no responsiveness more traditional options, such as morphine. The researchers are urging that any patient being considered for ziconotide treatment first undergo a thorough psychiatric evaluation and then be followed and monitored closely for depressive symptoms and any emergent suicidal thoughts.