Predicting Response to AntiDepressant Medication

As social workers we often hear clients voice frustration that medication provides little or no relief in their depressive symptoms. A few nights ago I was parked in front of the TV channel surfing when I came across an interview with Dr Andrew Leuchter, principal researcher in a study called EEG Biomarkers for Predicting Response to Antidepressant Therapy.

According to Dr Leuchter, “We can tell by the changes that occur within the first few days of drug treatment whether the brain is responding in such a way that the patient will eventually get better.” (Source: Stephanie Stahl, Finding The Right Antidepressant, visited on the Internet on 6/19/07 at http://cbs3.com/health/local_story_169175757.html)

How can he tell? Patients are evaluated for changes in their brain’s electrical activity with a device which employs electroencephalogram (EEG) technology using fewer electrodes than the typical EEG machine you may have seen. The device is reportedly demonstrating a 70-80% success rate in predicting whether medication will be effective on a long-term basis after a single week of treatment. (Source: Emily Singer, 5/29/07,Transforming the Psychiatrist’s Office: New technologies for treating depression could make the couch obsolete, visited on the Internet on 6/19/07 at http://www.technologyreview.com/Biotech/18791/)

Wouldn’t it be great if the psychiatrists we work with were able to predict with reasonable accuracy if a medication will work? This research definitely sounds like a step in the right direction. But if you read the exclusion criteria, you’ll see that the results may not be appropriate to generalize to depressed individuals with substance abuse issues. Or to women in general due to the birth control stipulation, which I assume means oral contraceptives. And then there are those poor souls who never seem to respond to medication despite years of compliance with their prescribed medication regimen.

I’ll be curious to see how this shakes out and whether it will result in new methods of monitoring our clients’ symptoms in addition to their responses to antidepressant medications.

 

2 responses


  1. This is an area that I feel passionate about. Over twenty years I have had work situations which have been wonderful and others, leaving me questioning how in the world I ended up here.
    My concern is that with all the pressure to “look good” for whatever auditing or accreditation agencies we have the shift has balanced precariously, putting paperwork conformance first and clinical issues second. In recent times I have had positions where the opportunity to discuss client related issues and the things that really excite me about clinical practice get ignored, with more concern about whether I signed my progress note fully. I have done some recent research on workplace issues and have spoken with authorities in the field and am told that as social workers we have every right to consult our professional code if we feel that we are being asked to do something that challenges our values. I think that overemphasis on the paperwork from administrators who are not necessarily social workers trickle down to morale issues for managers, supervisors and supervisees. But no one seems to know how to change that.


  2. as someone who has done a considerable amount of fee for service over the course of my career. the issue of social work salary has been a crucial one. Though the NASW strongly advocates that fee for service workers receive adequate compensation for what we do, typically in fee for service we get paid a specific hourly rate for client contact but the paperwork details and other ancillary tasks often having us putting in our own time in order to conform to administrative compliance. The hourly rate might look great on paper, but the follow up and collateral contacts we need to maintain plus the added factor of no shows and cancellations makes for a bleak situation. Because of the fact that our hourly rate might look generous, when you look at the total equation, some of us find ourselves with barely enough earnings to drive to work, let alone purchase health benefits.

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