AI technique can determine if antidepressants are working after one week

It is well known that the commonly used antidepressant sertraline, better known under the brand name Zoloft, works well for some and not at all for others. An AI algorithm developed by researchers at Amsterdam UMC and Radboudumc in Nijmegen can now help doctors determine after a week whether a patient is sensitive to the drug, instead of the typical six to eight weeks of trial and error, the university hospitals announced.

The AI algorithm predicts whether the antidepressant will work based on a brain scan and an individual's clinical information. The researchers tested their algorithm by seeing whether they could predict the effect of sertraline in a previous study conducted in the United States.

In that study, 229 patients with severe depression underwent MRI scans and had their clinical data recorded before and after a week of treatment with sertraline or a placebo. The Dutch researchers’ algorithm could predict that sertraline would work for only a third of the patients in that study.

“The algorithm suggested that those who had a lot of blood flow in the anterior cingulate cortex, the area of the brain involved in emotion regulation, would be helped by the drug,” said Eric Ruhé, a psychiatrist at Radboudumc. That turned out to be the case at the second measurement, a week after the patients started taking the antidepressant, based on the severity of their symptoms

Sertraline is one of the most prescribed antidepressants in Europe and the United States. In the Netherlands, some 126,000 people use it. “With this method, we can already prevent two-thirds of the number of ‘erroneous’ prescriptions of sertraline and thus offer better quality of care for the patient,” said Liesbeth Reneman, professor of Neuroradiology at Amsterdam UMC.

The researchers hope that their method can help better tailor sertraline treatment to the individual patient. “Currently, there is no exact science. The patient is given the medication, and after six to eight weeks - in practice, often up to six months - it is checked whether it works. If the symptoms do not subside, the patient is given another antidepressant, and this process can repeat itself several times,” Amsterdam UMC said.

All that time, the patient is still struggling with their depression symptoms, combined with side effects from antidepressants, which can include nausea, dizziness, insomnia, and sexual dysfunction, among other things.

The results of the study are published in the American Journal of Psychiatry. The researchers hope their method can eventually also help test the effectiveness of other antidepressants.