There are many drugs to treat depression, but doctors are still uncertain about how to prescribe them appropriately. It appears that about two thirds of the patients don’t respond adequately to the treatment, so doctors need to prescribe the drugs based on ‘trial and error’. But this may be about to change, according to a new study published in Nature’s journal Neuropsychopharmacology. Its authors have found at least three biomarkers – based on high levels of inflammation – which indicate high resistance to mild or low-dose antidepressants.
‘The study shows that we could use a blood-based “test” to personalise the treatment of depression,’ says co-author Carmine Pariante of King’s College London’s Institute of Psychiatry. ‘If a patient had high levels of inflammation, they could immediately begin with a more intensive treatment programme, such as combining antidepressants or stepping up the doses.’
The results are based on the effects of an 8-week treatment over 74 depressed patients with either escitalopram or nortriptyline, two common types of antidepressants.
‘This is a small study, but the findings are promising,’ the researchers said. ‘Personalised treatments for depression could help us avoid the current ‘trial and error’ way of prescribing antidepressant medication.’
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Annamaria Cattaneo, Massimo Gennarelli, Rudolf Uher, Gerome Breen, Anne Farmer, Katherine J Aitchison, Ian W Craig, Christoph Anacker, Patricia A Zunsztain, Peter McGuffin, & Carmine M Pariante (2012). Candidate Genes Expression Profile Associated with Antidepressants Response in the GENDEP Study: Differentiating between Baseline ‘Predictors’ and Longitudinal ‘Targets’ Neuropsychopharmacology DOI: 10.1038/npp.2012.191