Depression can seriously affect your daily life and wading to determine which will work for you can be time-consuming and frustrating. Now, however, there can be a means to get past the inefficiency of trial-and-error and figure out which course of treatment will confer the most gain, based on a small study published in the journal JAMA Psychiatry.
Using a brain scan, researchers identified a biomarker that indicates whether patients who need treatment due to their depression would be better off experiencing or using antidepressants.
“Our aim is to develop reliable biomarkers that match an individual patient to the treatment alternative probably to be successful, while also avoiding those that will probably be ineffective,” Helen Mayberg, MD, study author and researcher with Emory University in Atlanta, said in a statement.
Researchers conducted brain scans before they compared the brain activity of the patients who benefited from treatment to the ones who didn’t 12 weeks later, and started treatment. They found that high activity on one specific section of the brain called the anterior insula signaled the patients would benefit from antidepressants over psychotherapy, whereas low activity in the area suggested the opposite – a finding that researchers say can result in better treatment alternatives for patients with depression.
“At present, treatment failure with antidepressant drugs regularly results in the inclusion of another drug rather than a categorical substitution to an evidence-based psychotherapy,” the researchers wrote in the study. “Results herein suggest that patients who require [psychotherapy] have a distinct neurophysiology that differs categorically from patients who need [antidepressants].”
But David M. Reiss, MD, a psychiatrist based in San Diego, said combining treatments is probably a better option.
“In every one among the over 10,000 instances I ‘ve evaluated and treated, the mode of intervention has changed with time based upon the patient’s reaction to treatment, state, and life situation, etc. – none of which stay static,” he said. “I cannot recall an individual case in which I have not combined aspects of different therapeutic strategies in order to best address the distress, issues, symptomatology, and pathology present at any point in time for the specific patient being treated.”
The researchers acknowledged the findings remain preliminary, and said it is not too late to urge brain scans before treatment for patients with depression. Nevertheless, they urged additional research, and said they treating depression could become much easier.
“If these findings are confirmed in follow up replication studies, scans of anterior insula process could become clinically helpful to direct more effective initial treatment choices,” Dr. Mayberg said in the statement, “offering a first step towards personalized medicine measures in the treatment of major depression.”
Steve Maraboli, PhD, a behavioral scientist and author of the Everyday Health site The Healthy, Empowered Life, said he looks forward to the day when this technique comes to fruition.
“In this age of high tech computer computations, we’re seeing the consequences of medical research data being gathered and examined for critical use as predictors for effective personalized medical management,” Dr. Maraboli said. “With so many variants in initial identification and treatment considerations, it’ll be intriguing to see if doctors find this biomarker effective in accurately forecasting the most effective course of health actions.”