It seems to be an extensive, slow struggle to treat major depression. Many medications for curing depression are believed to have been obtainable. However no single biomarker or diagnostic test appears to exist in order to predict which one is accurate for an individual. Accordingly, the first drug prescribed fails to function for more than half of the patients and the reason for this seems to be unknown.
According to a latest study led by UCLA, clinicians may now be able to precisely predict within a week whether a particular drug could possibly be effective in treating major depression. This detection would be possibly with the help of a non-invasive test which takes less than 15 minutes to administer. If the patients require a more effective treatment then the test may perhaps allow physicians to rapidly switch patients towards it.
Major depressive disorder is known to be a leading cause of disability. This disorder was estimated to have cost society in excess of $80 billion per year. Additionally, nearly two-thirds of these costs seem to reflect the enormous disability associated with the disorder. An estimated 15 million people in the United States are noted to have been suffering a depressive period every year. Also, nearly 17 percent of adults could perhaps experience major depression in their lifetime.
This study is called as the Biomarkers for Rapid Identification of Treatment Effectiveness in Major Depression (BRITE-MD). Supposedly, BRITE-MD measures changes in brain-wave patterns by utilizing quantitative electroencephalography (QEEG).
QEEG is known to be a non-invasive, computerized measurement which recognizes specific alterations in brain-wave activity. These changes were believed to have preceded improvement in mood by many weeks. Also, these changes serve as a biomarker which accurately seemed to have predicted how effective a particular medicine will be.
Nearly nine sites across the country collaborated on the study, which enrolled approximately 375 people who had been diagnosed with major depressive disorder (MDD). Before the tests, each individual was given a baseline QEEG and then prescribed an antidepressant escitalopram. Escitalopram is commonly known as Lexapro, a category of drugs known as selective serotonin re-uptake inhibitors which are commonly prescribed for depression.
After one week, a second QEEG was taken. Furthermore, experts examined a biomarker called the antidepressant treatment response (ATR) index. ATR appears to be a specific change in brain-wave patterns from the baseline QEEG.
Subjects were then noted to have been randomly told to continue with escitalopram or were given a different drug. A total of 73 patients who remained on escitalopram were believed to have been tracked for about 49 days in order to check whether their findings matched the prediction of the ATR biomarker.
“Until now, other than waiting, there has been no reliable method for predicting whether a medication would lead to a good response or remission. And that wait can be as long as 14 weeks. So these are very exciting findings for the patient suffering from depression. The BRITE results are a milestone in our efforts to develop clinically useful biomarkers for predicting treatment response in MDD,” says lead author of the study, Dr. Andrew Leuchter, professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA.
The findings revealed that the ATR seems to have predicted both response and reduction with an accuracy rate of approximately 74 percent which was much higher other than any other method obtainable. Experts also found that they could possibly predict whether subjects were more susceptible in responding to a different antidepressant, bupropion, also known as Wellbutrin XL.
Leuchter further said that, “BRITE study results suggest that the ATR biomarker could potentially provide the greatest clinical benefit for those patients who might be receiving a medication that is unlikely to help them. Our results suggest that it may be possible to switch these patients to a more effective treatment quickly. This would help patients and their physicians avoid the frustration, risk and expense of long and ineffective medication trials.”
He claimed that this study has shown that patients suffering from depression who do not get better with a first treatment seem to experience prolonged suffering. Further, they are noted to be more susceptible in completely abandoning the treatment and may become more resistant to treatment eventually.
“So the benefits to the individual and to society are enormous,” continues Leuchter.
He was of the opinion that an added benefit of the biomarker test is that it seems to be non-invasive, painless and quick involving only about 15 minutes. In addition, it is believed to occupy the placement of six electrodes around the forehead and on the earlobes.
The findings of the study have been published in the journal Psychiatry Research.