Researchers across the country affiliated with the Department of Veterans Affairs, including two Yale psychiatry professors, are studying the best second-line treatments for depression.
The study, funded with a $24 million grant from the Department of Veterans Affairs, was initiated by Somaia Mohamed, MD, PhD, Associate Professor of Psychiatry at the Yale University School of Medicine, and Sidney Zisook, MD, Professor of Psychiatry at the University of California, San Diego.
Mohamed and Zisook are co-chair and co-principal investigators of the effort, called The VA Augmentation and Switching Treatments for Improving Depression Outcomes (VAST-D) Study.
Researchers recruited 1,521 patients at 35 VA sites across the country, including at the VA Medical Center in West Haven, to participate.
Locally, Deepak C. D’Souza, MBBS, MD, Professor of Psychiatry at the Yale University School of Medicine, was the investigator at the West Haven site.
The study seeks to determine which of three interventions is best for treatment-resistant depression. Research shows that the first antidepressant does not successfully treat two-thirds of people with major depression, so the study seeks to help health care providers know which treatment to use next.
The study compares three second-line treatment options: a switch to another antidepressant, a supplement with a second antidepressant, or a supplement with an antipsychotic drug like Abilify.
The recent paper presents the innovative methods used in this unique and definitive study.
Somaia Mohamed, MD, PhD, Associate Professor of Psychiatry
“The problem is you can’t look at all of the treatment options at one time,” said Paul Hicks, MD, PhD, Vice Dean of the Temple Campus of the Texas A&M Health Science Center College of Medicine and a member of a 12-person executive committee leading the study. “That would be prohibitively expensive and would require far more patients than practical. However, this study will give a definitive idea about which of three promising interventions is likely to be effective.”
Mohamed said she was pleased researchers enrolled more patients than the target of 1,500.
"This is usually a major challenge in psychiatric studies, so we have received a commendation from the VA R&D and were asked to write a briefing to help other investigators conducting psychiatric studies," she said in a statement. "The recent paper presents the innovative methods used in this unique and definitive study."
Treatment-resistant depression is defined as depression symptoms that do not go away after treatment at an adequate dose of medication for an adequate period of time. Patients usually either switch to a different antidepressant or add a second medication to their current one. There is, however, little clinical guidance about what is most effective.
The study attempts to give health care providers more information about what option is best for patients who do not respond to the first antidepressant they are prescribed.
The results of the study are scheduled to be published in 2016.