In patients with major depression disorder it is, thanks to use of artificial intelligence, now possible to predict within a week whether an antidepressant will work. By inputting a brain scan and an individual's clinical information into an AI algorithm, researchers from Amsterdam UMC and Radboudumc could see up to 8 weeks faster whether or not the medication would work. The results of this study are published today in the American Journal of Psychiatry. 

"This is important news for patients. Normally, it takes 6 to 8 weeks before it is known whether an antidepressant will work," says Professor of Neuroradiology at Amsterdam UMC, Liesbeth Reneman. 

The research team analysed whether they could predict the effect of the antidepressant sertraline, the most commonly prescribed in the United States. In a previous study conducted in the United States, MRI scans and clinical data were administered to 229 patients with major depression before and after a week of treatment with sertraline or placebo. The Amsterdam researchers then developed and applied an algorithm to this data.  

This analysis showed that the drug would only work for a third of patients, allowing psychiatrists to adjust their treatment plan.  "With this method, we can already prevent 2/3 of the number of 'erroneous' prescriptions of sertraline and thus offer better quality of care for the patient. Because the drug also has side effects," says Reneman.  

The right drug, much faster 

"The algorithm suggested that those who had a lot of blood flow in the anterior cingulate cortex, the area of brain involved in emotion regulation, would be helped by the drug. And at the second measurement, a week after the start, this turned out to be the severity of their symptoms" says Eric Ruhé, psychiatrist at Radboudumc. 

In the future, this new method may help to better tailor sertraline treatment to the individual patient. Currently, there is no exact science. The patient is given the medication and after 6 to 8 weeks – in practice often up to six months – it is checked whether it works. If the symptoms do not subside, the patient is given another antidepressant, and this process can repeat itself several times. This standard method often takes weeks, if not months. It also saves society costs, because as long as the patient continues to suffer from the serious depressive symptoms, he or she cannot fully participate in society.  

Follow-up examination 

In one in three depressed patients, there is still no improvement in the symptoms after several treatment steps. Therefore, there is an urgent need for a solution that allows a faster determination of the effectiveness of antidepressants in severe depression. In the coming period, the researchers will improve the algorithm by adding extra information   

Read the full study here: Treatment Response Prediction in Major Depressive Disorder Using Multimodal MRI and Clinical Data: Secondary Analysis of a Randomized Clinical Trial | American Journal of Psychiatry (psychiatryonline.org)