A test to predict a drug’s success?

A good way to speed up the process of finding an effective antidepressant would be to learn sooner whether a particular drug was going to work.

One experimental approach is the use of noninvasive tests to examine brain function in people who have recently started taking an antidepressant. The brain’s response might predict whether the person would ultimately benefit from the drug.

Another approach under study is testing people for genetic variations that affect whether they respond to a particular drug.

Dr. Brian P. Brennan, a clinical researcher at Harvard University’s McLean Hospital’s Biological Psychiatry Laboratory, said that he and other researchers are experimenting with the use of neuroimaging tests (such as functional MRI, magnetic resonance spectroscopy and positron emission tomography) and electrophysiologic studies to examine brain function in people who have recently started taking an antidepressant.

Changes in the brain’s prefrontal or cingulate regions might predict whether the person would ultimately respond to the drug. But Brennan said that the only way to achieve real advances in the medical treatment of depression is for companies to move beyond developing more “me-too” drugs and start creating new classes of drugs that go beyond targeting neurotransmitters such as serotonin and norepinephrine.

“A huge number of people don’t respond to the drugs we have,” he said. “There must be a biological abnormality in some people with depression that we’re not even touching yet.”

-- Devon Schuyler