A new form of precision psychiatry is currently being investigated to match specific and personalized treatments for depressed patients. Nearly half of Americans seek treatment for a mental condition every year, especially since new services such as online psychiatry made therapy much more accessible. Depression, in particular, is a leading cause of disability which affects 6.9 percent of the United States population. However, finding the right therapy for a depressed patient is often an extremely complex and arduous process that forces many patients to quit before they find a solution.
There are many different anti-depressant medications available on the market, every one of them coming with its pros and cons. Choosing the right one that will be most effective for a specific patient frequently requires many tries. These medications, in fact, need several weeks before they become effective, but depending on the specific patient, even after the initial period, they simply fail to act and a new medication must be tried. In the meanwhile, however, the patient is exposed to the worst side effects which will slowly subside over time. But if the correct medication is not found quickly enough, a depressed individual may simply decide to stop taking his or her pills leading to a negative outcome.
How could precision psychiatry help?
According to a study published in Personalized Medicine in Psychiatry, a new precision approach might be used to tailor the ideal treatment to each patient by using his body mass index (BMI), sex and symptom profile. The researchers from the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, analyzed data from 659 adults affected by clinical depression. The subjects were randomly assigned one of three antidepressants (sertraline, escitalopram, or venlafaxine-XR) for an eight-week treatment.
The study found that both male and female patients with a larger BMI than normal reacted better to venlafaxine-XR, mostly because they experienced fewer side effects such as anxiety, increased appetite, and sleep disturbances. The opposite occurred with escitalopram, however, with patients with lower BMIs responding better to treatment and showing an improvement of all their symptoms. More in general, instead, all female patients with the highest BMI tolerated better all the physical side effects of the three different drugs, leading to more positive outcomes.
If the study result can be expanded to more medications and different patients profiles, precision psychiatry can significantly improve patient outcome for all types of depression in the near future.
Article by Dr. Claudio Butticè, Pharm.D.