Friday, July 18, 2014

Study Finds That Common Lab Test Can Help Predict Antidepressant Treatment Response


Researchers have been studying the interaction between inflammation and depression for decades. Now a team of Canadian and European scientists report in AJP in Advance on a way to help predict treatment outcomes based on levels of C-reactive protein (CRP), a biomarker of systemic inflammation. The study was part of the Genome-Based Therapeutic Drugs for Depression (GENDEP) study and compared outcomes in patients randomized to the SSRI escitalopram (n=115) or the tricyclic antidepressant nortriptyline (n=126). GENDEP is a multinational study sponsored by the European Commission designed to identify genetic markers that can help physicians decide which antidepressant is likely to be effective in a particular patient.

Patients with low baseline levels of CRP improved more with escitalopram, while those with higher CRP levels did better with nortriptyline, as measured on the Montgomery-├ůsberg Depression Rating Scale, reported Rudolph Uher, M.D., Ph.D., an associate professor of psychiatry at Dalhousie University in Halifax, Nova Scotia, and colleagues. “The effect size of the differential prediction met criteria for clinical significance, suggesting that the prediction can be meaningful in individual cases.”

The study must be replicated and tested with other antidepressants, said Uher. However, this exploration of the different effects of norepinephrine and serotonin on the immune system may open doors to predict how patients respond to treatments and perhaps narrow the trial-and-error process of finding the right antidepressant for each individual.

To read more about research on the connection between inflammation and depression, see the Psychiatric News articles, “Cytokine Antagonists May Help Some Depression Patients” and "Scientists Closer to Finding Tests for Depression Biomarkers."

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