Magazine article Clinical Psychiatry News

EEG Test Could Predict Antidepressant Response

Magazine article Clinical Psychiatry News

EEG Test Could Predict Antidepressant Response

Article excerpt

VIENNA -- A quantitative EEG bio-marker shows considerable promise for prediction of antidepressant response in major depression, Dr. Andrew J. Leuchter said at the annual congress of the European College of Neuropsychopharmacology.

The biomarker is obtained via an abbreviated frontal EEG study conducted after 1 week of therapy. The potential here is that the current and often prolonged trial-and-error approach to finding an effective antidepressant for an individual with major depression could be replaced by a 10- to 15-minute quantitative EEG study analyzed using proprietary technology in real time in a physician's office, explained Dr. Leuchter.

"Eventually, I could see this being deployed as part of an algorithm where you give somebody an antidepressant for a week, do the biomarker test, if it's negative switch to something else, [and] then get another biomarker indicator. You could eventually take an 18-month treatment algorithm and telescope it down to just 8 weeks by successively testing one drug after another," he said in an interview.

Dr. Leuchter, director of the brain, behavior, and pharmacology laboratory at the University of California, Los Angeles, presented an interim report on the first 111 of a planned 375 patients with major depressive disorder participating in the ongoing Biomarkers for Rapid Identification of Treatment Effectiveness in Major Depression (BRITE-MD) study.

All subjects had a baseline quantitative EEG using technology developed by Aspect Medical Systems Inc., the study sponsor. Patients then were placed on 10 mg/day of escitalopram (Lexapro). One week later, they returned for another quantitative EEG and were randomized to 7 weeks of continued escitalopram, augmentation with 300 mg/day of bupropion XL (Wellbutrin XL), or a switch to bupropion XL.

Prior studies by Dr. Leuchter and his colleagues established that a reduction in prefrontal theta band cordance between baseline and week-1 quantitative EEGs constitutes a biomarker predicting favorable response to treatment.

The key finding in BRITE-MD was that patients managed according to their EEG-predicted antidepressant response--that is, those who either had a positive biomarker and remained on escitalopram or had a negative biomarker and were switched to bupropion XL--had a 68% response rate as defined by a 50% or greater reduction in their baseline Hamilton Depression Rating Scale score after 7 weeks of treatment. …

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