aPfizer Drug Safety Research & Development, Groton, CT, USAbHalozyme Inc, San Diego, CA, USAcDrinker, Biddle and IQ Consortium, Washington, DC, USAdKallman Preclinical Consulting, Greenfield, IN, USAeSanofi Research & Development, Montpellier, FrancefGlaxoSmithKline Safety Pharmacology Department, Ware, UKgEli Lilly and Company, Indianapolis, IN, USAhJanssen Research & Development, Titusville, NJ, USAiJanssen Research & Development, Beerse, BelgiumjALA BioPharm Consulting, Gurnee, IL, USA
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Given the serious nature of suicidal ideation and behavior (SIB) and the possibility of treatment-emergent SIB, pharmaceutical companies are now applying more proactive approaches in clinical trials and are considering the value of nonclinical models to predict SIB. The current review summarizes nonclinical approaches to modeling three common risk factors associated with SIB: aggression, impulsivity, and anhedonia. For each risk factor, a general description, advantages and disadvantages, species considerations, nonclinical to clinical translation, and pharmacological validation with respect to treatments associated with SIB are summarized. From this review, several gaps were identified that need to be addressed before use of these nonclinical models can be considered a viable option to predict the relative risk for SIB. Other future directions that may compliment these nonclinical approaches, including the use of selectively-bred or genetically-modified rodent models, transgenic models, gene expression profiling, and biomarker analysis, are discussed. This article was developed with the support of the DruSafe Leadership Group of the International Consortium for Innovation and Quality in Pharmaceutical Development (IQ, www.iqconsortium.org).HighlightsTreatment-emergent suicidal ideation and behavior (SIB) is a serious concern.Nonclinical models that may assess treatment-emergent SIB are reviewed.Gaps must be addressed to build confidence in the translation of nonclinical models.