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A better way to prescribe for depression


It’s always a challenge to find the right antidepressant or combination of antidepressants for a patient. Given the weeks it takes to see improvement, valuable time can be lost as doctors attempt to find that perfect prescription. As many as 60% of depressed patients do not respond to the first prescription they take to treat depression.

Now, Loyola University Medical Center researchers are reporting a reliable method for predicting antidepressant efficacy.

The new method includes a blood test for a protein called vascular endothelial growth factor (VEGF). The study reports that among depressed patients who had higher than normal VEGF, more than 85% experienced partial or complete relief from depression after taking escitalopram (Lexapro). Fewer than 10% of depressed persons with lower than normal VEGF responded to the drug.

“This would be the first time we would have a predictor for how well a patient would respond to an antidepressant,” said Angelos Halaris, MD, PhD, and first author of the study. “It would greatly benefit our patients if we could predict ahead of time whether a given medication would be effective for a certain patient.”

No one knows why some serotonin reuptake inhibitors (SSRIs) work for some patients and not for others. SSRIs themselves are not completely understood. It could be that they help restore a chemical balance in the brain. Another idea is that they action help regenerate brain cells in specific parts of the brain, a process referred to as neurogenesis.

For this particular study, it looks like neurogenesis is playing a role. The escitalopram may be jump starting brain cells that have become inactive. For patients with high levels of VEGF, this may be the place to start.

Source: Loyola University, ScienceDaily

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