Research on the correct dosage of antidepressants

A gene-based personal treatment plan is expected to provide faster treatment with fewer problems. side effects

The Radboudumc Start a study on the personal dosage of antidepressants in patients with severe depression. This dose is based on the hereditary predisposition to break down the drugs in the liver. A gene-based personal treatment plan should allow faster treatment with fewer side effects.

Tricyclic antidepressants play an important role in the treatment of severe depression. These drugs are often used when ordinary antidepressants (called SSRIs) are not used. A correct dosage is necessary for a good treatment. If the dose is too low, the antidepressant does not work or does not work as well. If the dose is too high, the risks of side effects are greater.

At the present time, it takes a long time to prepare patients at the right dose. This is not the same for everyone. Indeed, there are big differences in the speed with which the liver breaks down the drug. For Joost Janzing, head of research and psychiatrist, these differences are hereditary: "We want to be able to determine in advance how much medicine a person needs.We do this by determining the variations in the genes These genes code for the enzymes that break down the drug in the liver.The higher the activity of these genes, the more the enzyme is rich, the faster the drug is broken down. "

With Using the result of the genetic test, the correct dosage can be prescribed immediately. The assay on the basis of the test is compared to the assay in the usual way. Researchers expect patients to recover faster and have fewer side effects when using the genetic test. During the course of the research, the participants are intensively monitored, the effects and side effects being measured weekly.

Predicting a person's genetic information to be able to better dose medications is relatively new. Due to the progress of this pharmacogenetics, treatments can be more and more adapted to each individual. The determination of CYP genes for antidepressant testing is one of the first practical applications, says Joost Janzing: "The added value of prior checking of genes is plausible on a theoretical basis." In this study, we want to map the effects clinical practice test. "

There are approximately 50,000 patients with severe depression each year for whom tricyclic antidepressant therapy is relevant. Researchers estimate that the use of pharmacogenetics can save $ 12 million in health costs and $ 63 million in social costs. The research was set up in the Radboudumc with a grant from ZonMw and is conducted on patients from Radboudumc, Pro Persona (sites Nijmegen, Arnhem, Ede and Tiel), Vincent van Gogh (North Limburg), Reinier van Arkel (Hertogenbosch) and Erasmus MC (Rotterdam).