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 Guided by this test, the researchers said, doctors should in future
be able to direct depressed patients with a certain level of
inflammation in their blood toward earlier treatment with a more
potent course of antidepressants, possibly including combining two
medications, before they get worse.
"This study moves us a step closer to providing personalized
antidepressant treatment at the earliest signs of depression," said
Annamaria Cattaneo, who led the work at King's College London's
Institute of Psychiatry, Psychology & Neuroscience (IoPPN)
Depression is one of the most common forms of mental illness,
affecting more than 350 million people worldwide. It is ranked by
the World Health Organization as the leading cause of disability
globally.
Treatment usually involves either medication, some form of
psychotherapy, or a combination of both. But around half of all
people treated for depression fail to get better with first-line
antidepressants, and around a third of patients are resistant to all
available medications designed to help.
Until now, doctors have not been able to establish whether someone
will respond to an antidepressant, or whether they might need a more
aggressive treatment plan from the start.
As a result, patients are often treated with a trial-and-error
approach, trying one drug after another for months on end and often
seeing no improvement in their symptoms.
In this study, published on Tuesday in the International Journal of
Neuropsychopharmacology, Cattaneo's team focused on two biomarkers
that measure blood inflammation.
Previous studies have already linked raised levels of inflammation
with a poor response to antidepressants.
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The researchers measured the two markers, called Macrophage
Migration Inhibitory Factor (MIF) and interleukin (IL)-1β, in two
groups of depressed patients before or after they took a range of
commonly prescribed antidepressants.
They found that blood readings above a certain threshold could
reliably predict the probability of a patient responding.
Patients with MIF and IL-1β levels above the thresholds had a 100
percent chance of not responding to conventional, commonly
prescribed antidepressants, the researchers found, while those with
lower levels did show a positive treatment response.
Carmine Pariante, a IoPPN professor who worked on the team, said the
results point to a "clinically-suitable approach for personalizing
antidepressant therapy".
(Editing by Richard Balmforth)
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