Will the anti-depressant you take work? Researchers looking for clues: smiles included

As more Americans take antidepressants, the feeling is that the already large numbers may grow considerably in the stress-filled world we are in. Look how turbulent the past 12 days have been in light of the elections.

What if we can predict what antidepressants would work for some patients, or not, based on their childhood stresses, and brain activity, and studying their facial expressions, such as smiles?

That could mean a big difference, not only for patients, but for healthcare, and its spending on medications.

A team from Stanford University led a study to do that very thing; they “created a model, based on brain activity and exposure to stress in childhood, that predicts the likelihood that antidepressants will benefit a patient,” according to a recent National Institutes of Health Research Matters story Predicting the Usefulness of Antidepressants. The model has a80 percent accuracy for prediction of antidepressants helping patients.

“Addressing this question could provide a new mechanistic understanding of why some individuals respond to antidepressant treatments and others do not, as well as offer new targets for intervention,” the researchers said in the study.

The study findings indicate that many patients who faced stressful situations should be considered for other therapy techniques before medication.

Certainly, however, many people are now taking the meds.

In 2013, Roni Caryn Rabin of The New York Times wrote that the use of antidepressants skyrocketed, with one of 10 Americans taking antidepressant medications. Last November, Justin Karter reported in Mad in America that from 1999 to 2012, the percentage of Americans on antidepressants increased from 6.8% to 13%, citing the Journal of American Medical Association.

Not only are the numbers increasing, but a report in the Medical Daily show that most people take some type of anti-depressants, even though they don’t need it.

Finding the keys to antidepressants

As Tianna Hicklin, a writer at the NIH who wrote about the federal agency sponsored study, notes, antidepressant medications usually are linked to the treatment of depression, but done so as a result of a “trial and error” process.

So researchers looked into the mechanism of depression, examining patients’ stressors at childhood, and the brain’s handling of emotions. They reviewed  data from 70 patients who had  major depressive disorders, and asked them how many life stressors they had experienced before age 18, Hincklin wrote. Those stressors could include abuse, neglect, family conflict, illness, or death and natural disasters, she said.

In the meantime, the  researchers evaluated the amygdala activity of the brain linked to depression. Amygdala is a mass of gray matter inside each cerebral hemisphere. The researchers found that amygdala circuitry and early life stress (ELS) are both “strongly and independently implicated in the neurology of depression,” the team, led by Leanne Williams and Andrea-Golstein-Piekarski said. Williams did not respond to questions from Health Data Buzz.

Impact of Smiles

Using an MRI, the researchers measured brain activity in patients  and  viewed pictures of “emotional faces,” including smiling,  Hicklin wrote. Brain scans were taken before and after patients started taking antidepressants.

Ironically, antidepressants were less likely to work for those patients considered in the high -stress category, but “these patients had a greater chance of benefiting from the medications if their brains were highly responsive to happy facial expressions,” Hicklin added.

Also, patients with low childhood stress were most likely to benefit from antidepressant treatment. Their chances increased if their brains were less sensitive to both happy and fearful stimuli,” according to Hicklin.

“These results suggest that, for some patients, it might help to first try therapy techniques that address the impact of trauma in a person’s life before considering medication,” she wrote.




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