Brain scans could help predict whether antidepressants will work


Scientists have long been trying to find out why some people do not respond to antidepressants. Now, new research suggests that it may be possible to predict how well a person with depression will respond to medication by analyzing scans of their brains. The research includes an example of how artificial intelligence (AI) can help the analysis.
By using brain scans and AI, researchers believe that they could predict how well some antidepressants might work.
The new research comes in the form of two recent studies, one that features in the American Journal of Psychiatry and the other in Nature Human Behaviour.
The studies reveal the most recent findings from a clinical trial in the United States called Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC).
EMBARC aims to set up objective tests derived from patient biology to help select treatments for mood disorders and reduce the trial and error of prescribing medications.
Dr. Madhukar H. Trivedi, a professor in the Department of Psychiatry at the University of Texas (UT) Southwestern Medical Center in Dallas, is overseeing the trial. He is also the senior author of the two recent papers. “We need to end the guessing game and find objective measures for prescribing interventions that will work,” said Dr. Trivedi, who is also the founding Director of the Center for Depression Research and Clinical Care at UT Southwestern.
“People with depression already suffer from hopelessness,” he adds, “and the problem can become worse if they take a medication that is ineffective.”
A major reason for setting up EMBARC was because an earlier study that Dr. Trivedi led had found that nearly two-thirds of people fail to respond adequately to their first depression medication.
Most people have moments of sadness or feeling low that can last for days, particularly following distressing events. Depression, however, is a psychiatric condition in which these and other symptoms are more severe and do not go away.
The symptoms of depression include persistent feelings of sadness and hopelessness and loss of interest in activities that were once enjoyable.
Other symptoms can also occur, such as irritability, anxiety, fatigue, restlessness, and difficulties in making decisions and concentration. No two individuals with depression will necessarily experience the same symptoms, and even when they do, it does not mean that a treatment that works for one will work for the other.
According to the nonprofit organization Our World in Data, the number of people with depression worldwide has risen from almost 170 million in 1990 to nearly 265 million in 2017, with females more likely to be living with depression than males. Dr. Trivedi and colleagues started the 16-week EMBARC trial in 2012. It ran in four locations in the U.S. and investigated a total of 296 people with major depressive disorder.

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