In an effort to develop “best-fit, personalized regimen(s)” for treating depression, researchers at Tel Aviv University in Israel are undertaking a research program designed to identify genes that are associated with extreme responses to particular antidepressants such as Prozac. "Many drugs for treating depression are on the market," said Dr. David Gurwitz, leader of the new program. "The most popular ones, including Prozac, are the selective serotonin reuptake inhibitors (SSRIs). But they only work for about 60% of people with depression. A drug from other families of antidepressants could be effective for the other 40%," he said. "We are working to move the treatment of depression from a trial-and-error approach to a best-fit, personalized regimen. We've designed an experiment to search for elements that can determine who will, and who won't, benefit from drugs such as Prozac." The researchers will explore whole-genome gene expression profiles in cell lines from healthy people. Because Prozac and similar antidepressants are known to inhibit the growth of blood cells, the researchers are now screening a large collection of cell lines to determine which have the strongest and weakest growth-inhibition responses to SSRIs like Prozac. Those cells that exhibit extreme responses will then be screened across the entire human genome, to find out which genetic make-up works best with SSRIs. "Psychiatric pharmacology remains a black box," said Dr. Gurwitz. "Nobody knows why some people respond to Prozac-type SSRI anti-depressants, while others are helped by other kinds of antidepressants. The World Health Organization predicts by the year 2020, costs and lost productivity from depression will exceed those of cardiovascular disease as the leading cause of health expenditure in developed countries.
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