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NOS Nieuws•vandaag, 06:00
The commonly used antidepressant setraline does not work for everyone with depression, but who does and who does not? Doctors can now determine this using an algorithm developed at the Amsterdam UMC. As a result, it is now clear after a week whether a patient is sensitive to the drug, while previously this took six to eight weeks.
Setraline, better known under the brand name Zoloft, is one of the most prescribed antidepressants, both in the Netherlands and in the rest of Europe and the United States. In the Netherlands, 126,000 people use the drug. The new research shows that approximately two-thirds of the number of prescriptions for the drug can be omitted because it has no effect on these patients.
Side effects
“With this research, psychiatrists can better say for whom antidepressants work and for whom they do not,” says Maarten Poirot, a PhD student involved in the research. “Right now it’s mostly trial and error. It can take six months for a patient to complete a cycle.” During this time, they may suffer from side effects such as nausea, dizziness, insomnia or sexual disorders.
For the analysis, the Amsterdam and Nijmegen researchers used data from a large American study, in which 229 patients who suffered from major depression participated. They were given setraline or a placebo. A brain scan was made both before and after the start of treatment.
Blood supply
Whether the drug worked turned out to depend largely on the blood supply to a brain area that regulates emotions. Even the scan made before the treatment turned out to have a predictive value. One week after the start of treatment, the severity of the symptoms mainly contributed to the predictive value. The study has been published in the leading journal American Journal of Psychiatry.
“We have known for some time that cerebral blood flow plays a role,” says professor of neuroradiology Liesbeth Reneman, lead researcher of the study. “But that only allowed us to make predictions at the group level. Now we can predict it for each individual. It is a step towards personalized medicine.”
Wider application
Reneman is hopeful that the test can also be used for other antidepressants. Setraline belongs to a group of antidepressants that have a similar effect, the so-called serotonin reuptake inhibitors (SSRIs). “Our expectation is that all SSRIs will respond in approximately the same way. We want to investigate in the near future whether this is indeed the case.”
The test is not yet used in practice. “It still has to enter the treatment room,” says Poirot. “Psychiatrists will have to write a referral for a brain scan. The process to realize this will take some time.”
2024-02-07 05:00:09
#technology #effectiveness #antidepressants #clear #week
