What antidepressant works for you? Brain scans can now predict
Antidepressants — they keep millions of people functioning on a daily basis, while at the same time stabilizing the levels of the neurotransmitter serotonin. These types of treatments are also known for treating depressive and anxiety disorders. However, due to the vast selection of different antidepressants to choose from, it may take months before you find the right treatment.
But according to a new study, science is starting to change that. Researchers at the Semel Institute for Neuroscience and Human Behavior at UCLA conducted a study which aimed at predicting the effectiveness of an antidepressant using brainwave recordings.
A simple biomarker (a pair of brain-wave recordings) can forecast whether the person will enter remission after just one week of treatment, UCLA researchers suggested.
According to Dr. Andrew Leuchter, the lead author of the study, this new research can help eliminate the long, stressful wait time for those who hop from one medication to another, hoping to find the right one. “Knowing whether a medication is going to work could eliminate weeks of waiting for the patient, and get them on effective treatment more quickly.”
When testing the selective serotonin reuptake inhibitor (SSRI) antidepressant Lexapro, generically known as escitalopram, researchers were able to predict recovery from depression using electroencephalogram recordings.
Like other antidepressants, Lexapro’s primary mechanism of action comprises of increasing the levels of serotonin, a neurotransmitter located in the presynaptic cell, by limiting reabsorption. This mechanism of action consequently causes a change in mood and behavior, thus treating depressive symptoms.
Serotonin levels in the brain are also responsible for stabilizing the slow and faster brain waves, researchers stated. The brain uses this ratio between fast and slow waves to form chemical or electrical networks that support a healthy mood and thinking. This ratio between the slow and fast waves causes a chemical reaction which helps regulate the mood and thinking patterns in the brain.
“The researchers tested whether brainwave recordings in the first week of treatment would show that the antidepressant (as compared with a placebo) corrected the frequency imbalance — and predict a beneficial effect of medication on an individual’s depression after seven weeks of treatment,” UCLA wrote.
All in all, researchers collected data from 194 people, aged between 18 to 70 years old, all with clinical depression. The study was broken down into three separate groups: two comprised of 70 and 76 patients, each treated with Lexapro for seven weeks, and the third group of 48 patients treated with a placebo.
The groups who received Lexapro were placed in other studies to analyze just how effective this particular SSRI drug works compared to other types of antidepressants. All the patients were subjected to an electroencephalogram before taking any drugs, and the second one after patients completed one full week of treatment or placebo.
Researchers quickly noticed that after one week of therapy with Lexapro, patients began responding with distinct brain wave recordings in contrast to the other subjects. The brain wave recordings did not, however, predict treatment results for those who received a placebo instead of an antidepressant.
“Our biomarker selectively predicted remission with medication, but not placebo. This confirmed that we can differentiate a true, specific response to a drug from a non-specific placebo response. To our knowledge, this is the first time that a biomarker that differentiates placebo remission from drug remission has been reported,” Dr. Leuchter said.
With this much progress in place, researchers are now turning their attention towards other antidepressant drugs.
Researchers are planning to investigate other antidepressants using the same brain wave recording technique, with hopes to shorten the wait time for depressive patients in the near future.