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Abstract: Low serotonin neurotransmission is thought to increase vulnerability to suicidal behavior. To test this hypothesis, we measured brain regional serotonin synthesis, as indexed by PET and α-[11C]methyl-l-tryptophan trapping, in 10 patients who had made a high-lethality suicide attempt and 16 healthy controls. Compared to healthy controls, suicide attempters had reduced normalized α-[11C]methyl-l-tryptophan trapping in orbital and ventromedial prefrontal cortex. α-[11C]Methyl-l-tryptophan trapping in these regions correlated negatively with suicide intent. Low serotonin synthesis in the prefrontal cortex might lower the threshold for suicidal behavior. [Copyright &y& Elsevier]