Genetic Code Key to More Effective Depression Treatments

The year is now edging into that time where thousands of people begin to feel a little blue and just want to curl up under a blanket. This is called Seasonal Affective Disorder and can be treated with a mild antidepressant until it subsides in the spring but what about those whose constant struggle with depression has them feeling like every treatment has let them down?

Coming Closer to More Effective Depression Treatment

Medications Alone Aren’t Helping

A psychiatry research team at Yale-New Haven Hospital have been looking into new ways of combining drugs for more effective treatments. There are now over 70 years of depression research, but no drug has been able to stem the rate of suicide. In many cases, medications have worked no better than a placebo would have and, unfortunately, the drugs available just can’t help some patients.

Current Treatments

The most commonly known and prescribed class of drugs is the selective serotonin reuptake inhibitor (SSRI.) These drugs include brands like Prozac, Zoloft, Paxil, and Lexapro regulate the amount of serotonin in the brain. However, rates of response aren’t nearly where they need to be, studies have shown that only 1 in 3 patients respond to SSRIs, and they can take several weeks before improvement is seen.

The First Mixed Drug Class Trials

About 20 years ago, the STAR*D trial found that response rates could be raised from the initial 30 percent to as high as 70 percent if patients either switched SSRIs, combined two SSRIs, or added a low-dose second-generation antipsychotic such as aripiprazole, quetiapine, and olanzapine plus fluoxetine.

Promising New Developments

Recently, researchers have been finding that combining certain classes of medications increase their effectiveness. Most notably, developing new versions of ketamine, which work in the higher centers of the brain, where researchers suspect depression lies in some cases. Current treatments target chemical systems like serotonin and dopamine, which are “very basic” areas of the brain. A study using ketamine to treat depression far exceeded expectations — showing a high rate of response within 24 hours.

Genetic Code is Key

There is no single gene that causes depression or any other mental illness, but researchers are investigating large data sets to predict how specific genetic patterns lead to certain types of mental illness and which medications, if any, are most likely to work. This is called personalized medicine, also known as precision medicine and could be the key physicians need to treat their patients more quickly and effectively.

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