|A study from Dr. Madhukar Trivedi (front) |
demonstrated that measuring a depressed
patient's C-reactive protein level can help
doctors prescribe an antidepressant that is
more likely to work.
Credit: UT Southwestern
Doctors can for the first time determine which medication is more likely to help a patient overcome depression, according to research that pushes the medical field beyond what has essentially been a guessing game of prescribing antidepressants. A blood test that measures a certain type of protein level provides an immediate tool for physicians who until now have relied heavily on patient questionnaires to choose a treatment.
“Currently, our selection of depression medications is not any more superior than flipping a coin, and yet that is what we do. Now we have a biological explanation to guide treatment of depression,” said Dr. Trivedi, who led the research at UT Southwestern Medical Center’s Center for Depression Research and Clinical Care.
The study, published in Psychoneuroendocrinology, demonstrated that measuring a patient’s C-reactive protein (CRP) levels through a simple finger-prick blood test can help doctors prescribe a medication that is more likely to work. Utilizing this test in clinical visits could lead to a significant boost in the success rate of depressed patients who commonly struggle to find effective treatments.
The research measured remission rates of more than 100 depressed patients prescribed either escitalopram alone or escitalopram plus bupropion. Researchers found a strong correlation between CRP levels and which drug regimen improved their symptoms:
- For patients whose CRP levels were less than 1 milligram per liter, escitalopram alone was more effective: 57 percent remission rate compared to less than 30 percent on the other drug.
- For patients with higher CRP levels, escitalopram plus bupropion was more likely to work: 51 percent remission rate compared to 33 percent on escitalopram alone.
The next step is to conduct larger studies to verify CRP’s role with other antidepressants and find alternative markers where CRP does not prove effective. Dr. Trivedi said these studies could lead to additional useful biological tests that can be used in practice.