Antidepressants or cognitive behavioral therapy? A new study has just shown that the electroencephalogram can help doctors decide on the best care to follow to treat depression.
This It is not always easy for a clinician to know from the start of treatment whether a depressed patient will react better to a drug, because in this disease, the clinical effect only appears after an average delay of 3 to 4 weeks. If it takes 3 to 4 weeks to know if a patient responds to one treatment, it will take 6 to 8 weeks to know if he responds to a second. A very important delay which leaves the patient suffering for too long and which is not without consequences for the prognosis: the longer one waits, the more a depression risks becoming resistant to treatment.
Hence the importance for physicians of having an early biomarker of the response to antidepressant treatment. A new study, published in the Journal of Clinical Psychiatry, has just demonstrated that the electroencephalogram can help them to decide quickly if a patient will respond to treatment: this examination, common and non-invasive, also called EEG, is able to detect very early the return of a cerebral phenomenon, “the ‘positive apprehension’.
Brain activity during the apprehension of a positive event
In the context of depression, the activity of the brain during the apprehension of a positive event decreases. This is colloquially known as “seeing everything black”. Conversely, the more the depressive symptoms disappear, the more the activity of the brain associated with a positive event increases again. The electroencephalogram is able to measure this level of activity.
Based on these assumptions, the researchers tested the reaction to positive events of 63 depressive patients. For twelve weeks, a first group received cognitive behavioral therapy, while a second group took an antidepressant every day. At the end of the experiment, if the electroencephalogram indicated that the brain activity associated with a positive event (earning money) had increased during the follow-up period, it could be concluded that the treatment was good. Otherwise, it meant that antidepressants or cognitive behavioral therapy were ineffective in treating the depressed patient.
“Until now, there was no objective way to assess the effectiveness of treatment for depression at such an early stage,” says Katie Burkhouse, lead author of the study. “Antidepressants can have unwanted side effects, while practitioners trained in cognitive behavioral therapy can be hard to find,” she explains. Thus, knowing more upstream what type of treatment works on a patient would avoid many pitfalls, and would allow faster relief of depressive symptoms.
One in five people affected by depression
In France, it is estimated that nearly one in five people has suffered or will suffer from depression during his life. Depression is a disease that affects all ages, from childhood to very late in life. In 2010, 7.5% of 15-85 year olds experienced a depressive episode, with a prevalence twice as high among women as among men (Source: National Institute for Prevention and Health Education). However, depression does not only affect adults. The prevalence of depressive disorders is estimated between 2.1 to 3.4% in children and 14% in adolescents.
The World Health Organization (WHO) considers depressive disorders to be the 1st factor of morbidity and disability worldwide.
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