Doctor develops online predictor for antidepressant effectiveness


When a depressed person visits a psychiatrist for treatment, he or she is likely to be prescribed medication.

With so many medications on the market and the mechanisms in the brain not entirely understood, it is hard to know which medication is going to do the most good, most expeditiously.

The ability to know the likelihood that a certain antidepressant will work would be an important development in the treatment of depression.

Antidepressants are difficult to match to patients

In fact, the effectiveness of current medications is lower than previously expected. Effectiveness varies across patients. The largest antidepressant trial ever conducted, the NIMH STAR*D study, provided discouraging news about the effectiveness of depression medications: Only 30 percent of patients responded to their initial prescription, and after one year (and as many as four different treatments), 30 percent of patients never did respond and achieve remission.

Risk calculator developed to estimate resistance

Dr. Roy Perlis at Massachusetts General Hospital has taken an important step toward achieving an accurate predictor for the effectiveness of prescription antidepressants for particular patients. He gathered data from the STAR*D study and used several models to identify statistical patterns. He generated an online risk calculator and visualization tool that creates a graphical estimate of risk for treatment resistance.

“To address the needs of individual depressed patients, we will need to find ways to design psychiatric treatments to respond to the differences among patients with depression,” said Dr. John Krystal, editor of Biological Psychiatry. “The ‘depression calculator’ that emerges from the STAR*D trial is one step forward in this effort. To do better than this, we will need to include biomarkers that may serve the function that blood tests and blood pressure measurements serve in other areas of medicine.”

“It’s far from perfect, and there’s plenty to criticize – but it has at least spurred efforts to use prediction in a clinical setting,” Perlis explained. “It has also provided a platform to which biomarkers can be added, as they are identified.”

It should be noted that this is not a tool for consumers. The risk calculator is in the developmental stages and is being tested by clinicians.

Source: MedicalNewsToday, Biological Psychiatry


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