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

Babies can learn that hard work pays off

September 21, 2017
If at first you don't succeed, try, try again. A new study from MIT reveals that babies as young as 15 months can learn to follow this advice. The researchers found that babies who watched an adult struggle at two different ...

Oxytocin turns up the volume of your social environment

September 20, 2017
Before you shop for the "cuddle" hormone oxytocin to relieve stress and enhance your social life, read this: a new study from the University of California, Davis, suggests that sometimes, blocking the action of oxytocin in ...

Researchers develop new tool to assess individual's level of wisdom

September 20, 2017
Researchers at University of San Diego School of Medicine have developed a new tool called the San Diego Wisdom Scale (SD-WISE) to assess an individual's level of wisdom, based upon a conceptualization of wisdom as a trait ...

Alcohol use affects levels of cholesterol regulator through epigenetics

September 20, 2017
In an analysis of the epigenomes of people and mice, researchers at Johns Hopkins Medicine and the National Institutes of Health report that drinking alcohol may induce changes to a cholesterol-regulating gene.

Self-control may not diminish throughout the day

September 20, 2017
After a long day of work and carefully watching what you eat, you might expect your self-control to slip a little by kicking back and cracking open a bag of potato chips.

One in four girls is depressed at age 14, new study reveals

September 20, 2017
New research shows a quarter of girls (24%) and one in 10 boys (9%) are depressed at age 14.

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.