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Measurable
changes in the front of the brain can predict the effectiveness
of antidepressant medications within days of treatment, even
before a patient starts to feel better, according to researchers
at UCLA.
Using
quantitative EEG, a non-invasive computerized measurement
of brain wave patterns, researchers found that specific changes
in brain-wave activity came before clinical changes resulting
from the use of antidepressant medication.
"Up
to 40 percent of depressed patients do not respond to the
first medication they try. Since it takes several weeks for
an effective treatment to produce clear improvement, doctors
often wait six to 12 weeks to decide that a particular medication
just isn't right for that patient and move on to anther treatment,"
said Dr. Ian A. Cook, assistant professor in the UCLA Department
of Psychiatry and Biobehavioral Sciences and lead author of
the study.
"By
comparing EEG measurements before treatment with those soon
after treatment begins, doctors may be able to evaluate the
usefulness of an antidepressant within days rather than having
to wait weeks to months," said Cook. "This technique
also could slash the time and costs needed to develop and
research new antidepressants."
Researchers
studied 51 adult patients diagnosed with acute depression.
Each patient participated in one of two, double-blind, randomized
treatments. One group was given Prozac (fluoxetine) or a placebo
and the other group was given Effexor (venlafaxine) or a placebo.
Each patient received a quantitative EEG before beginning
treatment and again after 48 hours and after one week after
treatment.
A total
of 52 percent of the patients responded to medication and
38 percent responded to the placebo. Those who responded to
medication showed significant decreases in a specific measure
of brain wave activity at 48 hours and one week. Clinical
changes were seen after four weeks. Patients with the greatest
change in brain wave activity had the most complete response
to the medication after eight weeks, according to the study
published in the journal Neuropsychopharmacology.
"Other
researchers have compared brain scans of depressed people
before and after treatment and found differences between those
who recovered and those who did not respond," said Cook.
"Those findings, however, do not allow prediction of
whether a particular patients is likely to get well. This
is the first study to detect specific changes in brain wave
activity that precede the clinical changes in a way that can
usefully predict response."
Investigators
are continuing the research to determine if the results prove
true using other antidepressants. They are also working to
simplify the EEG method to make it easier for physicians to
use this approach in caring for their patients.
Source:
Depression Week
of June 23, 2002
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