Monday, April 10, 2017

Treating depression is guesswork. Psychiatrists are beginning to crack the code. - Vox

Here's a frustrating fact for anyone who has been prescribed medication or therapy for depression: Your doctor doesn't know what treatment will work for you.

"It is currently complete primitive guesswork," Leanne Maree Williams, a professor at Stanford University, says. "It's hard to imagine how you can do worse than the current situation, to be honest."

Depression means being stuck in a chronic state of sad mood or lack of enjoyment in life, to a degree where it starts to degrade quality of life. The two main treatments are cognitive behavioral therapy (CBT), a talk-centered approach that gets patients to readjust their habits, and antidepressant medications.

Both are about equally effective. Around 40 percent of patients will get better on either.

But no one treatment reliably works for everyone. And it's not just about talk therapy versus drugs. Even in the realm of medication, available drugs like Zoloft and Cymbalta will work for some but not others.

Enter "precision psychiatry." Inspired in part by "precision medicine," which changed the way doctors treat certain kinds of cancer, psychiatric researchers are hoping to bring a "precision" approach to diagnosing and treating depression using brain scans and machine learning algorithms. Too many patients are left frustrated after treatments fail. These scientists think they can do better.

More ...

http://www.vox.com/science-and-health/2017/4/4/15073652/precision-psychiatry-depression