Genome-based therapeutic drugs for depression (GENDEP)
This international research project aimed to find a way to use information about patients’ genes to help doctors decide which anti-depressant would work best for individuals and which would have the least side effects. The results could lead to the development of a genetic test to help doctors choose the right anti-depressants for individual patients.
At some point in their lives, one in five people suffers from depression severe enough for doctors to prescribe medication. But some patients don’t respond to some types of anti-depressants, or may develop side effects. These patients may not get better until they are prescribed another type of drug. At the moment, choosing which type of anti-depressant to prescribe is almost an educated guess: doctors simply don’t have enough information to predict which patients will respond to which type of drug.
1,000 people with depression were recruited from ten European countries, and were treated with one of two types of drugs (escitalopram or nortriptyline), one that affects serotonin in the brain and the other that affects noradrenaline, another chemical messenger. The research team monitored their progress and any side effects for six months, and then compared how patients fared with information about their genetic make-up, determined through a blood sample. Researchers aimed to find out if they could link individuals’ genetic profile with their response to different types of medication.
Researchers also carried out basic research using cells grown in the laboratory to find out more about how anti-depressants work and how they affect the nervous system. This may lead to the development of better medication. They also lookied at the cost-effectiveness of the two types of anti-depressants, and whether a patient’s genetic profile made a difference to the cost-effectiveness.
The GENDEP Project was funded by the European Commission, and a team based in the Social, Genetic and Developmental Psychiatry Centre at the IoP led the project. Professor Martin Knapp
in the Centre for the Economics of Mental Health carried out the economic evaluation. Scientists, clinicians and industrial partners came from the ten participating countries - UK, Ireland, Belgium, Germany, Sweden, Italy, Denmark, Slovenia, Poland and Croatia.