For the first time in decades,
researchers have identified a new medication that can successfully treat major
depression.
An existing oral drug may relieve major
depression.
Depression affects
about 300 million people across the globe, making the condition
the "leading cause of ill health and disability worldwide," according
to the World Health Organization (WHO).
In 2016 in the United States,
over 10 millionadults had at least one major depressive episode.
Approximately 64 percent of these people had their lives severely impaired as a
result.
Despite the prevalence and severity
of this condition, the current treatments are limited and often ineffective. Up
to 30 percent of people with major depression are resistant
to treatment.
Furthermore, some studies have
suggested that antidepressants may have a host of
unexpected side effects, such as raising the risk of stroke and heart attack or that
of premature mortality.
Now, new research finds hope for
treating major depression in an existing anticonvulsant drug called ezogabine.
Scientists at the Icahn School of
Medicine at Mount Sinai in New York City, NY, tested the drug in 18
participants who were having a major depressive episode but not taking any
medication.
Dr. James Murrough, the director of
the Mood and Anxiety Disorders Program at the Icahn School of Medicine, is the
senior author of the paper, which now appears in
the journal Molecular Psychiatry.
First new
depression medicine for decades
For the new research, Dr. Murrough
and his colleagues drew from one of their previous studies, in which they
showed that ezogabine, or retigabine, was successful in treating
depression-like symptoms in mice.
The drug is a potassium channel
opener. As the researchers explain, previous studies have shown that potassium
channels in the brain's ventral striatum — a region involved in processing
reward — mediate the brain's resilience to depression.
In the new study, Dr. Murrough and
team administered up to 900 milligrams of ezogabine, orally, to 18 people with
major depressive disorder for a period of 10 weeks.
Using functional MRI scanners, the researchers
examined the participants' brain circuitry pre- and post-treatment, looking to
see whether the drug had had any effect on their brains' reward systems.
The study
revealed that ezogabine led to a 45 percent reduction in depressive symptoms,
as measured by the activity in the brain's reward circuitry.
More specifically, an
"[i]mprovement in depression was associated with decreased functional
connectivity between the ventral caudate and clusters within the mid-cingulate
cortex and posterior cingulate cortex," report the researchers.
Also, a subgroup of participants
showed improved reward learning after the treatment. The study's senior
investigator comments on the findings, saying, "The results of this study
are exciting because we haven't had a new medicine to treat depression in
decades."
"Most antidepressants are in the same class of drugs
and work by increasing serotonin. Our research
suggests a different molecular target that works through other brain mechanisms
and could be helpful for patients."
Dr.
James Murrough
"We know that patients with
depression become depressed for different reasons, and we've been stuck in a
one-size-fits-all treatment for a long time," Dr. Murrough adds.
"A new class of medicines could
give us an opportunity to treat patients based on the specific underlying cause
of their disease."
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