MedicalResearch.com Interview with:
Turhan Canli, Ph.D.
Associate Professor, Psychology and Radiology
Director, SCAN (Social, Cognitive, and Affective Neuroscience) Center
Senior Fellow, Center for Medical Humanities, Compassionate Care, and Bioethics Stony Brook University Stony Brook, NY 11794
Medical Research: What is the background for this study? What are the main findings?
Response: I was struck by two aspects of major depression treatment.
First, that today’s drug treatments are not much different from those used decades ago, with no real progress in treatment effectiveness. In severe cases of major depression, antidepressants may give some symptom relief, but for less severe cases, the effectiveness of antidepressants is not clinically relevant.
Second, recurrence rates remain stubbornly high: patients with diagnosed MDD have a lifetime recurrency rate of 50%. We are not treating depression; at best, we reduce symptoms.
Medical Research: What should clinicians and patients take away from your report?
Response: Current treatment approaches are based on trial-and-error. Patients are prescribed medication and doses with no predictive ability. If a prescription works, great. If it does not, one changes the dose or the medication and reiterates the process until something works. And often, that dosage/medication eventually stops working, and the process begins anew. Wouldn’t it be amazing if we knew of specific parasites/bacteria/viruses that played a causal role in MDD, so that in the future, the first step in a patient’s treatment experience would be a panel of lab tests to identify the specific pathogen(s) to be targeted in the treatment strategy? Of course, we currently have no definitive scientific proof for any such associations. Nonetheless, clinicians would have the flexibility to at least test patients for possible known pathogens (e.g., a depressed patient who owns a cat to be tested for toxoplasmosis). A positive test could motivate treatment for the infection (assuming one is available), with the possibility that this treatment may also have beneficial effects on the patient’s mood.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: Future studies should embark on a concerted effort to search for pathogens that are associated with major depression. These studies should be designed not only to investigate known candidates, but discover novel ones.
Medical Research: Where can clinicians and patients find more information?
For those who are inclined to read academic papers, here is the link to the original paper:
For those without a scientific background, here is a link to a TEDx talk I gave on this topic, designed for a general lay audience: http://youtu.be/1dD29XHp6CU
Reconceptualizing major depressive disorder as an infectious disease
How to get teens, young adults with chronic conditions to take their medications
Biol Mood Anxiety Disord. 2014 Oct 21;4:10. doi: 10.1186/2045-5380-4-10.