Now, keep up to date
with daily feeds of newly posted stories
about America's Seniors...click on the box
to the left
Researchers develop Biomarker for rapid
relief of Major Depression
Newswise — It is a long, slow slog to treat
major depression. Many antidepressant
medications are available, but no single
biomarker or diagnostic test exists to
predict which one is right for an
individual.
As a result, for more than half of all
patients, the first drug prescribed doesn't
work, and it can take months to figure out
what does.
Now, based on the final results of a
nationwide study led by UCLA, clinicians may
be able to accurately predict within a week
whether a particular drug will be effective
by using a non-invasive test that takes less
than 15 minutes to administer.
The test will allow physicians to quickly
switch patients to a more effective
treatment, if necessary.
The study, called the Biomarkers for Rapid
Identification of Treatment Effectiveness in
Major Depression, or BRITE-MD, measured
changes in brain-wave patterns using
quantitative electroencephalography (QEEG),
a non-invasive, computerized measurement
that recognizes specific alterations in
brain-wave activity.
These changes precede improvement in mood by
many weeks and appear to serve as a
biomarker that accurately predicts how
effective a given medication will be.
The study results appear in two articles
published in the September issue of the
journal Psychiatry Research.
Nine sites around the country collaborated
on the study, which enrolled a total of 375
people who had been diagnosed with major
depressive disorder (MDD).
Each individual was given a baseline QEEG at
the beginning of the trial and then
prescribed the antidepressant escitalopram,
commonly known as Lexapro, one of a class of
drugs known as selective serotonin re-uptake
inhibitors that are commonly prescribed for
depression. After one week, a second QEEG
was taken.
The researchers examined a biomarker called
the antidepressant treatment response (ATR)
index — a specific change in brain-wave
patterns from the baseline QEEG.
Subjects were then randomly assigned to
continue with escitalopram or were given a
different drug.
A total of 73 patients who remained on
escitalopram were tracked for 49 days to see
if their results matched the prediction of
the ATR biomarker.
The ATR predicted both response and
remission with an accuracy rate of 74
percent, much higher than any other method
available.
The researchers also found that they could
predict whether subjects were more likely to
respond to a different antidepressant,
bupropion, also known as Wellbutrin XL.
"Until now, other than waiting, there has
been no reliable method for predicting
whether a medication would lead to a good
response or remission," said Dr. Andrew
Leuchter, professor of psychiatry at the
Semel Institute for Neuroscience and Human
Behavior at UCLA and lead author of the
study.
"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."
Major depressive disorder is a leading cause
of disability, costing society in excess of
$80 billion annually; approximately
two-thirds of these costs reflect the
enormous disability associated with the
disorder.
An estimated 15 million people in the United
States experience a depressive episode each
year, and nearly 17 percent of adults will
experience major depression in their
lifetime.
"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," Leuchter said.
"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."
Leuchter noted that research has shown that
depression patients who do not get better
with a first treatment experience prolonged
suffering, are more likely to abandon
treatment altogether and may become more
resistant to treatment over time.
"So the benefits to the individual and to
society are enormous," he said.
An added benefit of the biomarker test,
according to Leuchter, is that it is
non-invasive, painless and fast — about 15
minutes — and only involves the placement of
six electrodes around the forehead and on
the earlobes.
Aspect Medical Systems, which developed the
ATR biomarker, provided financial support
for the study.
Aspect also participated in the design and
conduct of the study; the collection,
management, analysis and interpretation of
the data; and the preparation and review of
the manuscript.
Final approval of the form and content of
the manuscript rested with the authors.
Other UCLA authors included Dr. Ian Cook,
Dr. Karl S. Burgoyne and Dr. James T.
McCracken. Leuchter is chair of Aspect's
neuroscience advisory board and has provided
scientific consultation to them.
The Semel Institute for Neuroscience and
Human Behavior is an interdisciplinary
research and education institute devoted to
the understanding of complex human behavior,
including the genetic, biological,
behavioral and sociocultural underpinnings
of normal behavior and the causes and
consequences of neuropsychiatric disorders.
In
addition to conducting fundamental research,
institute faculty seek to develop effective
treatments for neurological and psychiatric
disorders, improve access to mental health
services and shape national health policy
regarding neuropsychiatric disorders.
... ..
...
...