Researchers have found what could become the first reliable method to predict whether an antidepressant will work on a depressed patient.
The method would involve a blood test for a protein called vascular endothelial growth factor. A study by researchers at Loyola University Medical Center found that among depressed patients who had higher than normal blood levels of VEGF, more than 85% experienced partial or complete relief from depression after taking escitalopram (Lexapro). By comparison, fewer than 10% of depressed patients who had low levels of VEGF responded to the drug.
"This would be the first time we would have a predictor for how well a patient would respond to an antidepressant," Angelos Halaris, MD, PhD, first author of the study, said in a news release. Halaris presented results during the 2011 annual meeting of the Society of Biological Psychiatry and the 4th Annual Illinois Brain, Behavior and Immunity Meeting.
About 60% of depressed patients do not respond fully to the first prescribed medication, requiring doctors to prescribe different medications on a trial-and-error basis to find one that works.
Seeking a method for predicting ahead of time whether a given medication would be effective for a certain patient, researchers studied 35 patients who took escitalopram, a selective serotonin reuptake inhibitor, for major depressive disorder.
The Loyola study supports the neurogenesis theory of SSRIs — that they help to regenerate brain cells in specific parts of the brain that have atrophied in depressed patients. Escitalopram appears to jump-start brain cells that have become inactive. This regeneration is fueled by VEGF, which, in the brain, stimulates the growth of blood vessels and works in other ways to keep brain cells healthy and active.
Patients with higher levels of VEGF appeared to experience greater levels of regeneration, helping to reduce depression. Conversely, in patients with lower VEGF levels, there was less regeneration of brain cells and less relief from depression.
If the finding is confirmed by further studies, researchers said, it could lead to a blood test that would help physicians tailor treatment. In patients with low levels of VEGF, for example, physicians could skip SSRIs and try alternative classes of depressants, such as bupropion, or alternative therapies, such as psychotherapy or transcranial magnetic stimulation therapy.
Currently, a VEGF blood test would be expensive if performed for a patient. But the cost likely would come down significantly if a VEGF test were to become widely used, Halaris said.
The method would involve a blood test for a protein called vascular endothelial growth factor. A study by researchers at Loyola University Medical Center found that among depressed patients who had higher than normal blood levels of VEGF, more than 85% experienced partial or complete relief from depression after taking escitalopram (Lexapro). By comparison, fewer than 10% of depressed patients who had low levels of VEGF responded to the drug.
"This would be the first time we would have a predictor for how well a patient would respond to an antidepressant," Angelos Halaris, MD, PhD, first author of the study, said in a news release. Halaris presented results during the 2011 annual meeting of the Society of Biological Psychiatry and the 4th Annual Illinois Brain, Behavior and Immunity Meeting.
About 60% of depressed patients do not respond fully to the first prescribed medication, requiring doctors to prescribe different medications on a trial-and-error basis to find one that works.
Seeking a method for predicting ahead of time whether a given medication would be effective for a certain patient, researchers studied 35 patients who took escitalopram, a selective serotonin reuptake inhibitor, for major depressive disorder.
The Loyola study supports the neurogenesis theory of SSRIs — that they help to regenerate brain cells in specific parts of the brain that have atrophied in depressed patients. Escitalopram appears to jump-start brain cells that have become inactive. This regeneration is fueled by VEGF, which, in the brain, stimulates the growth of blood vessels and works in other ways to keep brain cells healthy and active.
Patients with higher levels of VEGF appeared to experience greater levels of regeneration, helping to reduce depression. Conversely, in patients with lower VEGF levels, there was less regeneration of brain cells and less relief from depression.
If the finding is confirmed by further studies, researchers said, it could lead to a blood test that would help physicians tailor treatment. In patients with low levels of VEGF, for example, physicians could skip SSRIs and try alternative classes of depressants, such as bupropion, or alternative therapies, such as psychotherapy or transcranial magnetic stimulation therapy.
Currently, a VEGF blood test would be expensive if performed for a patient. But the cost likely would come down significantly if a VEGF test were to become widely used, Halaris said.
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