In a new study, researchers have discovered that measuring brainwaves produced during REM sleep can predict whether a patient will respond to treatment from depression.
This enables patients to switch to a new treatment rather than continue the ineffective treatment (and the depression) for weeks without knowing the outcome.
The research was conducted by a team at the University of Basel.
Around 7% of adults suffer depression (also known as MDD, Major Depression Disorder) in any one year.
It’s a huge health burden, costing economies hundreds of billions of Euros/dollars each year. Around 27 million European and 17 million Americans suffer from MDD every year.
The standard treatment is antidepressants, normally Selective Serotonin Reuptake Inhibitors (SSRI’s), such as Prozac and Fluoxetine.
However, these can take weeks or months to show an effect, meaning that patients often have to face the depth of their depression for several weeks before even knowing if the treatment they are taking will work.
Around 50% of sufferers don’t respond to initial antidepressant treatment, which means that after four weeks of ineffective treatment, doctors have to change treatment strategy, and again have to wait for a response for another four weeks.
Being able to predict the response as early as after one week of treatment would be of huge benefit to depressed patients, and would shorten the treatment response time.
In the study, the team tested 37 patients with Major Depression. All were treated with antidepressants, but 15 were assigned to the control group, while the remaining 22 had their details given to the psychiatrist in charge of treatment.
All then had their brainwaves monitored during REM sleep (technically, this was a measurement of prefrontal theta cordance in REM sleep).
The psychiatrists in charge of the treatment group patients were under instructions to interpret the brainwaves to see if the treatment was working, and if not to change the treatment.
The overall aim was to see a 50% reduction in symptoms of depression, measured by the standard Hamilton Depression Rating Scale.
Doctors tested patients as early as one week after starting treatment, to see if the brainwaves indicated that the antidepressant treatment was likely to work.
Those patients who were unlikely to have successful treatment were immediately switched to a different treatment.
After 5 weeks it was found that 87.5% of these patients had an improved response, as opposed to just 20% in the control group.
The findings show that by predicting the non-response to antidepressant scientists were able to adapt the treatment strategy more or less immediately.
This enables doctors to significantly shorten the average duration between the start of antidepressant treatment and response, which is vital especially for seriously depressed patients.
It needs to be repeated with a larger group of patients to make sure that the results are consistent.
Patients need to be in a situation where their REM sleep can be monitored, so this requires more care than just giving the pill and waiting to see what happens.
This means that the treatment monitoring will be more expensive, although the researchers anticipate that will be offset by being able to give the right treatment much earlier.
One author of the study is Dr. Thorsten Mikoteit.
The study was presented at the ECNP Congress.
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