National Institutes of Mental Health has tapped Emory University to conduct a study that will explore the predictability of how individuals respond to treatments for depression.
Over the next five years, Emory will enroll 400 patients in a study for the Center for Intervention Development and Applied Research (CIDAR). Called "Predictors of Antidepressant Treatment Response," the study will enroll persons who have Major Depressive Disorder (MDD). Participants will receive biological and psychological evaluations, and then be provided an approved treatment for depression.
"There are several safe and effective treatments available for depression, but doctors have little to go on in choosing a particular therapy for an individual patient," says Charles B. Nemeroff, MD, PhD, principal investigator and professor and Reunette W. Harris Chair of the Department of Psychiatry and Behavioral Sciences. "Currently, their recommendations for treatment are based primarily on issues of cost, convenience, and their overall clinical experience."
The result of this unpredictability is that many people treated for depression must try several types of treatment before improving. Often, patients may have only partial, not complete, recovery from their symptoms, and some do not improve at all.
In this study, participants will first be evaluated through functional magnetic resonance imaging (fMRI), genetic testing, a stress hormone function test and a personality assessment.
After completing these evaluations, the participants will then be randomly assigned to receive either cognitive-behavioral therapy, or one of two antidepressant medications - escitalopram (Lexapro) or duloxetine (Cymbalta). Each of the medications used in the study is thought to work through different mechanisms in the brain.
Participants will receive one of these three treatments for 12 weeks, with regular doctor visits during that time. At the end of 12 weeks, the evaluation process will be repeated to measure the biological changes that have occurred with treatment. The total commitment for the study requires 14 weeks - two weeks for the evaluation and 12 weeks of treatment.
"The brain imaging segment of this study will help us to actually see the differences in the brain among different subgroups of patients," says Helen Mayberg, MD, co-principal investigator and professor of Psychiatry and Neurology at Emory. "We are looking for markers that might predict response to treatment and help us, in the future, better select the optimal treatment for a given patient."
Volunteers for the study must be ages18 to 65 years, and have been diagnosed, or diagnosable, with MDD but either have not been previously treated or have not had adequate treatment. There are no fees or costs for participation and compensation will not be provided.
A sister study also is being conducted at Emory which uses similar brain imaging techniques, but is open to all patients with MDD, regardless of whether or not they have been treated previously.
For more information or to participate in the study, call Boadie Dunlop, MD, at 404-778-6663.