Many of our Clinical Studies provide treatment, which may include medication, psychotherapy, or other approaches. Treatment is generally provided at no cost.
A Researcher’s Perspective
Is personalized medicine science fiction or can researchers really hope to individualize each patient’s depression treatment to finally do away with treatment by trial-and-error? An innovative new NIMH-funded research study to identify the best treatment based in a person’s unique biology recently finished recruiting patients at four sites nationwide. Depression Evaluation Service (DES) former Director Patrick J. McGrath, MD, has been a Principal Investigator of a study, Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC) here at Columbia Psychiatry and is excited about the study’s promise.
“Can we find a way to scientifically select the correct treatment for our patients with depression, without trial and error?” asks Dr. McGrath. For the first 8 weeks of the 16-week study participants were randomly assigned to receive either an SSRI (sertraline) or a placebo (sugar pill). After 8 weeks, patients who did not improve on sertraline were switched to bupropion extended release for an additional 8 weeks, and those who did not improve on placebo were switched to sertraline. Prior to the medication, each participant received an MRI, psychological testing, and an EEG, which records electrical signals in the brain. Both the MRI and EEG were done to assess brain function. Blood samples were also be collected for genetic analysis.
“This isn’t the first study to use some of these technologies to look at physiologic differences in people with depression, but it is the first to incorporate a whole battery of them in a single randomized research study of this size,” said Dr. McGrath. Collaborators on the study include Myrna Weissman, PhD, a leading Columbia epidemiologist studying depression; Ramin Parsey, MD, PhD, formerly of our department and now Chairman of Psychiatry at Stony Brook University; and Maria Oquendo, MD, formerly Columbia Psychiatry’s Vice Dean for Education and now chairman of Psychiatry at the University of Pennsylvania.
The EMBARC study has ended, and the results, now being analyzed, are eagerly anticipated not only by researchers but patients who have tried multiple medications but found the side effects intolerable or found improvement only after months and months of trial-and-error. Many other studies in our department are using similar strategies to investigate depression and other psychiatric conditions.
To volunteer for a research study at Columbia Psychiatry, call (212) 305-6001.
A Participant’s Perspective
A tweet about an intriguing new research study turned out to be an incredibly significant communication after Shauna (not her real name) got laid off from her job. The 28 year old, who moved to New York after graduate school, had been doing well; she’d met the man she wanted to marry and had found fulfillment in doing important and satisfying work for a non-profit. But for a month she tried to find a therapist knowing that, as the last to be hired, she may very well be the first casualty from a company facing the onslaught of a tough economy.
When she learned she was being let go, Shauna’s mood took a turn for the worse: “I could not leave my bed. I cried all day long.” Not only had she lost her income, but she was denied unemployment and she was unable to contribute some of the money for her own wedding.
After a screening she was enrolled in the EMBARC study. After beginning the study, she realized that she may have had low levels of depression throughout her life. Bouts of depression had surfaced at a very early age. Shauna noted that “The earliest depression I can remember is when I was six and I tried to kill myself.” Unable to articulate what was wrong exactly, Shauna had told her parents she thought she needed to go to a doctor but her concerns weren’t taken seriously.
Still, she did well in school and life was fairly uneventful until she developed panic attacks in her early 20s. “I was on medication twice for short amounts of time and I remember them telling me we have no way of knowing which drug will work best for you,” she said. Still her experience with treatment went well, a far cry from what she’s witnessed happen to a close friend whose depression persisted for a decade as he bounced from one medication to the next without improvement.
Shauna is doing well today and looking forward to her wedding day. Of EMBARC, she said: “It’s a really neat study and the idea of what it could do and how it could revolutionize treatment makes me very hopeful for the future.”