Better targeting of Antidepressants 2

• Research type

  Research Study

• Full title

  Better targeting of antidepressants in older people: the influence of age and genetic background on serotonin signalling

• IRAS ID

  39286

• Contact name

  Juliet E Wright

• Sponsor organisation

  Brighton and Sussex University Hospitals NHS Trust

• Eudract number

  2009-016716-20

• ISRCTN Number

  No number provided

• Clinicaltrials.gov Identifier

  No number provided

• Research summary

  Depression in older people is recognised as a major health problem affecting 10-15% of the population. Older patients with depression rapidly lose their independence and rely heavily on care delivered by family, friends and the NHS. Prompt treatment of the disease is essential as more serious consequences of depression, such as physical illness can develop. Selective Serotonin Reuptake Inhibitors (SSRIs) are the mainstay of treatment; however, older patients are at greater risk of hospital admission due to serious side effects (falls and confusion) and in some patients SSRIs are ineffective. Depression is caused by a reduction of a chemical in the brain called serotonin, which nerve cells use to communicate. A transporter called SERT acts to decrease serotonin levels in the brain. Antidepressant drugs stop this protein working, restoring serotonin levels to normal. However, older people have less SERT for antidepressants to work on and this may compromise effective treatment and increase the risk of side effects. In addition, genetic differences in SERT and other proteins involved in serotonin communication have also been shown to further reduce treatment and exacerbate side effects. Antidepressants can take a number of weeks or months to work, and it is therefore desirable to identify patients that will respond to these drugs at an early stage. This will ensure appropriate therapy is not delayed and will minimise the potential of unnecessary serious side effects that could also increase time in hospital and delay recovery. We aim to use a simple blood test to enable us to identify whether older patients will respond successfully to antidepressants. Identifying this patient group will allow treatment options to be tailored to patient needs, minimising unnecessary exposure to the potentially serious side effects of SSRI antidepressants.

• REC name

  London - Brighton & Sussex Research Ethics Committee

• REC reference

  09/H1107/116

• Date of REC Opinion

  24 Feb 2010

• REC opinion

  Further Information Favourable Opinion