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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Hugh on September 6, 2015, at 13:10:52
"Most clinicians in this field know that it is very challenging to treat patients with depression or anxiety because the drugs we have only initially work for about 50% of patients, and success goes down with each successive drug failure," Anthony Altar, PhD, senior vice president, Assurex Health, maker of the test that sponsored the study, told Medscape Medical News.
"So we are focusing on patients who do not have a good response to their current drug, and we are finding that patients do much better when their healthcare provider is aided by the GeneSight test results," he said.
To obtain test results, physicians take a cheek swab from their patient and send it to Assurex Health, where it is analyzed for DNA variations.
Results of the analysis are detailed in a report, and psychotropic medications are placed into one of three categories: use as directed; use with caution; or use with increased caution and with more frequent monitoring.
Complete article:
Posted by Phillipa on September 6, 2015, at 17:50:09
In reply to Test Predicts Drug Response in Depression, Anxiety, posted by Hugh on September 6, 2015, at 13:10:52
Hugh could you read the comments by the docs at bottom of article. I subscribe to Medscape with RN license #. Don't know if makes a difference or not but my name appeared at the comments section. My pdoc did this a couple of years ago. And he just said continue the same. Nothing about the meds? Maybe told him if was taking more than prescribed or levels? P
Posted by phidippus on September 6, 2015, at 18:31:02
In reply to Test Predicts Drug Response in Depression, Anxiety, posted by Hugh on September 6, 2015, at 13:10:52
These tests have a long way to go before they become valid clinical instruments.
Eric
Posted by Hugh on September 7, 2015, at 9:41:10
In reply to Re: Test Predicts Drug Response in Depression, Anxiety » Hugh, posted by Phillipa on September 6, 2015, at 17:50:09
Did you try GeneSight or YouScript?
Posted by Hugh on September 7, 2015, at 19:47:20
In reply to Re: Test Predicts Drug Response in Depression, Anxiety » Hugh, posted by phidippus on September 6, 2015, at 18:31:02
Referenced-EEG (rEEG) is used to try to determine which drug will work the best. This is from http://www.marketwired.com/press-release/referenced-eeg-reegr-shows-significant-improvement-pharmacotherapy-according-journal-1286665.htm
CNS Response today announced that physicians using Referenced-EEG (rEEG®) had "success" rates reaching 65 percent for patients with treatment-resistant depression, according to an article published today in the Journal of Psychiatric Research.
Referenced-EEG showed "significant improvement" in informing pharmacotherapy for treatment-resistant patients in a 12-week study, according to the Journal of Psychiatric Research article. The study, conducted at 12 medical sites including Harvard, Stanford and Cornell, shows that rEEG can provide important information for patients who have failed first-line treatment.
Posted by SLS on September 11, 2015, at 22:00:42
In reply to Test Predicts Drug Response in Depression, Anxiety, posted by Hugh on September 6, 2015, at 13:10:52
This is not new territory. I have seen this type of study before. I don't know the value of this information, though. The results of these tests are only an index of the metabolism of drugs rather than being a method of choosing between drugs with different mechanisms of action. Using the results of this study, one can simply adjust the target dosages of individual drugs and boost response rates. I could be wrong.
I think there are other ways to go that offer better drug selection. The rEEG sounds interesting. I never heard of it before.
SPECT?
FDG PET scans (baseline or functional)?
Receptor PET scans (includes transporters and other targets)?
fMRI?
PET/MRI hybrid scan?
Genetic tests for neurotransmitter transporters?
Genetic tests for BDNF gene transcription rate?
Dexamethasone suppression test (DST)?
Neurotransmitter receptor binding?
I had thought to use biological probes - including FDA approved drugs - in combination with FDG PET scans to assay changes in brain activity or to use receptor PET scans to assay receptor densities. This information can then be used to choose treatments according to a treatment response database established over time by one or more sites of investigation. The NIH clinical center or intramural NIH-funded programs might be the best sources of information. The database might not even be necessary if sufficient information can be collected using smaller prospective studies.
Just an idea.
- Scott
Posted by Hugh on September 14, 2015, at 10:55:41
In reply to Re: Test Predicts Drug Response in Depression, Anxiety » Hugh, posted by SLS on September 11, 2015, at 22:00:42
> The rEEG sounds interesting. I never heard of it before.
rEEG does sound interesting. I've been reading quite a bit about it lately, because a woman I know has anorexia, and the treatments she's received in the past year (antidepressants, psychotherapy, group therapy) have failed completely. Anorexia is one of the most difficult psychiatric disorders to treat. Standard treatments help fewer than 20% of sufferers. I found this claim that rEEG helped 80% of those with anorexia:
Referenced EEG has been standard practice at the Monte Nido Treatment Center, a residential program in California for patients with Eating Disorders. Over 150 patients at Monte Nido have utilized an rEEG to determine medication sensitivities. In a controlled trial of over eighty patients treated at Monte Nido, 80% of Anorexia Nervosa patients responded positively to the medications prescribed based on Referenced EEG results.
Complete article:
http://www.integrativemedicineformentalhealth.com/articles/greenblatt_beyond_basics.html
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