Antidepressant Selection Based on Symptom Clusters

Peter ForsterBest Practices, Major Depression, Testing

Can we do a better job of antidepressant selection based on symptom clusters, analyzed using machine learning techniques? Perhaps so. And if so we will avoid a great deal of unnecessary suffering as people try one medication after another until the find the right medication or combination of medications to treat their depression. That is the premise behind an ambitious …

Antidepressant Response Linked to Norepinephrine Transporter Genotype

Peter ForsterBest Practices, Major Depression, Testing, Treatments of Depression

A large study of patients treated with venlafaxine found that antidepressant response was linked to the norepinephrine transporter (NET) genotype. The study looked at response in a sample of 350 individuals over the age of 60 with severe depression (MADRS greater than or equal to 15) who were treated with venlafaxine up to a dose of 300 mg a day. …

Neurocognitive Testing Online

Peter ForsterBest Practices, Testing

Neurocognitive Testing Online Now Available Problems with memory, inattention, distractibility and cognitive function are common symptoms of mood and anxiety disorders. They may also be side effects of the medications used to treat those conditions. Or they may be a sign of some other condition that needs to be evaluated. How can these evaluated? A key part of a comprehensive assessment …

Genesight – Genetic Testing to Predict Medication Response

Peter ForsterGPS Update, Psychobiology, Testing

We have been using the Genecept Assay from Genomind for several years to help guide treatment selection in patients with either unusually high rates of side effects from medications or those who have failed multiple trials of medications. Although the test can be expensive, costing anywhere from a couple of hundred dollars to five hundred dollars or more, it is our experience …

Genetic Tests for Depression Updated 2023

Peter ForsterBest Practices, Major Depression, Psychobiology, Testing

Do Genetic Tests Help? Are genetic tests for depression treatment worthwhile? Or is this an expensive technology that is not ready for routine use? Peter Roy-Byrne, writing in NEJM Journal Watch seems to say that they aren’t worth it. Although some clinicians may argue that such testing “can’t hurt and might help,” current psychopharmacological practice is complex, usually including combinations …

Lithium and Genes

Peter ForsterBipolar Treatment, Psychobiology, Testing

Several studies have suggested that lithium response has a genetic component. Whether someone with bipolar will respond to treatment with lithium seems to be strongly associated with the presence or absence of a family history of response to the medication. A recent article in the Lancet reports the results of a genome-wide association study of lithium response in 2563 patients collected …

Functional Brain Imaging and Antidepressant Response

Peter ForsterBasic Science, Testing, Treatments of Depression

One of the most exciting initiatives currently in the important area of  the treatment of depression is the International Study to Predict Optimized Treatment in Depression (iSPOT-D). This large multi-center initiative is based on a private industry and academic partnership that is designed to both identify best practices in the treatment of depression and also commercialize them. The most recent publication from this …

Depression Screening Recommended

Peter ForsterBest Practices, Major Depression, Policy, Testing

Although it seems like nothing more than common sense, we were very pleased to see that the United States Preventive Services Task Force (USPSTF), which is the major organization responsible for guidelines for public health interventions in the United States, added depression screening for adults, in particular for pregnant women and women who recently given birth, to its short list of …

ABCB1 Gene Predicts Antidepressant Response

Peter ForsterBasic Science, Major Depression, Psychobiology, Testing, Treatments of Depression

An article that will soon appear in the American Journal of Psychiatry suggests that it may be possible to predict who will respond to different antidepressants using a genetic test. The study looked at whether by testing for specific genetic variants of a protein involved in transporting drugs and other potentially toxic substances into and out of cells and across the blood …