Biomarkers for antidepressant treatment response

September 20, 2012
Biomarkers for antidepressant treatment response

(Medical Xpress)—Researchers from King's College London's Institute of Psychiatry (IoP) have identified new biomarkers for antidepressant treatment response, an important step towards developing personalised treatments for depression. The study, published today in Neuropsychopharmacology, is the first to identify blood biomarkers for antidepressant response in a clinical controlled study and is part of Genome-Based Therapeutic Drugs for Depression (GENDEP) project.

Professor Carmine Pariante, lead author of the study at the IoP at King's says: 'We've identified in the blood which could help identify individuals less likely to respond to basic antidepressant treatment. This is a small study, but the findings are promising. Personalised treatments for depression could help us avoid the current 'trial and error' way of prescribing

'The study confirms previous evidence that increased inflammation is part of the mechanism leading to depression, especially to particular forms of depression that are less responsive to antidepressants. The study shows that we could use a blood-based "test" to personalise the treatment of depression. If a patient had high levels of inflammation, they could immediately begin with a more intensive treatment programme, such as combining antidepressants or stepping up the doses.' 

Researchers aimed to identify two types of biomarkers: ones which could predict future response to antidepressant treatment (predictors), and others which are targeted by antidepressants and change over the course of treatment (targets). 

Within , information from genes is transcribed into m-RNA before the effect is visible as a physical or biochemical characteristic. Previous research has shown that depression interferes with three key : the (GR) complex, inflammation levels and neuroplasticity. The researchers therefore monitored how mRNA was produced for 15 specific genes linked to these three systems. 

The study involved 74 depressed patients. Their levels of mRNA expression were tested before and after 8 weeks of treatment with either escitalopram (n=38) or nortriptyline (n=36).  Escitalopram, a serotonin reuptake inhibitor and nortriptyline, a tricyclic antidepressant, are both commonly prescribed first line antidepressant treatments in the UK. 

Individuals who did not respond well to treatment displayed significantly higher levels of three inflammation markers before treatment (IL-1B +33%; MIF +48% and TNF-a +39%), suggesting that these three biomarkers could be used to identify individuals who are least likely to respond to antidepressant treatment. 

Individuals who underwent successful antidepressant treatment displayed reduced levels of inflammation (IL-6 -9%) and GR function (FKBP5 -11%) markers and higher levels of neuroplasticity markers (BNDF +48% and VGF +20%). These 'target' markers are different from the 'predictor' markers, suggesting that antidepressants do not adequately target the high levels of inflammation displayed in hard to treat individuals. 

Professor Pariante adds: 'Additionally, these findings provide novel mechanistic insight into  mRNA gene expression changes associated with antidepressant response which is likely to generate new ideas for novel and more effective .'

Explore further: Dual medications for depression increases costs, side effects with no benefit to patients

More information: Cattaneo, A et al. 'Candidate gene expression profile associated with antidepressants response in the GENDEP study: differentiating between baseline "predictors" and longitudinal "targets"'  Neuropsychopharmacology  (19th September) doi: 10.1038/npp.2012.191

Related Stories

Dual medications for depression increases costs, side effects with no benefit to patients

May 2, 2011
Taking two medications for depression does not hasten recovery from the condition that affects 19 million Americans each year, researchers at UT Southwestern Medical Center have found in a national study.

Ibuprofen, aspirin, other anti-inflammatory drugs reduce effectiveness of SSRI antidepressants

April 25, 2011
Scientists at the Fisher Center for Alzheimer's Disease Research at The Rockefeller University, led by Paul Greengard, Ph.D., and Jennifer Warner-Schmidt, Ph.D., have shown that anti-inflammatory drugs, which include ibuprofen, ...

Recommended for you

Children with fragile X syndrome have a bias toward threatening emotion

August 23, 2017
Anxiety occurs at high rates in children with fragile X syndrome (FXS), the most common form of inherited intellectual disability. Children with co-occurring anxiety tend to fare worse, but it can be hard to identify in infants. ...

So-called "bright girl effect" does not last into adulthood

August 23, 2017
The notion that young females limit their own progress based on what they believe about their intelligence—called the "bright girl effect"—does not persist into adulthood, according to new research from Case Western Reserve ...

High moral reasoning associated with increased activity in the human brain's reward system

August 22, 2017
Individuals who have a high level of moral reasoning show increased activity in the brain's frontostriatal reward system, both during periods of rest and while performing a sequential risk taking and decision making task ...

Like adults, children show bias in attributing mental states to others

August 22, 2017
Young children are more likely to attribute mental states to characters that belong to the same group as them relative to characters that belong to an outside group, according to findings published in Psychological Science, ...

Yoga and meditation improve mind-body health and stress resilience

August 22, 2017
Many people report positive health effects from practicing yoga and meditation, and experience both mental and physical benefits from these practices. However, we still have much to learn about how exactly these practices ...

Wealth disparity and family income impact the brain development of female youth

August 22, 2017
Female teenagers living in neighbourhoods with wide salary gaps and a low-income household show changes to their brain maturation that could indicate a higher risk of developing mental illness in adulthood, suggests a recently ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.