Psychiatrists may soon be able to determine which antipsychotic drugs will work best for patients with schizophrenia or bipolar disorder, researchers say, cutting down on the time it takes for physicians to pinpoint the most effective treatment for patients and lessening the impact of side effects.
“The ultimate goal is to develop a strategy in which a simple brain scan could provide the necessary information to help select the best medication – or treatment approach – for an individual patient,” said the study’s co-author, Dr. Anil Malhotra, director of psychiatry research at the Zucker Hillside Hospital in New York City.
The test is still in development. Researchers say they want to fine tune its sensitivity before making it available to the public. But, the outlook looks promising.
Schizophrenia and bipolar disorder can be debilitating for patients as well as their loved ones. Antipsychotics, such as Risperdal (risperidone), are approved for both adults and children with these mental disorders. However, “We have no way to predict how an individual patient with schizophrenia is gong to respond to treatment,” Malhorta said. “Essentially, we use a trial-and-error approach to treatments.”
When antipsychotics don’t work, patients remain in a psychotic state, which can be both expensive and lead to other serious consequences including suicide or the abandonment of treatment. They also submit patients to unnecessary side effects, which can be devastating. For example, Risperdal side effects include gynecomastia risk, a condition in which boys grow breasts.
Preventing exposure to treatments that are not beneficial to patients would be priceless to both patients and their caregivers.
For the study, Malhorta and her team used MRI brain scans to develop a measurement of how the two sides of the brain communicate. This, in part, correlated with how patients improved when they took certain types of antipsychotic medications.
They tested this theory on 41 patients ages 15 to 40 who experienced their first so-called psychotic break. These patients underwent brain scans before being randomly assigned to take Risperdal or Abilify, another antipsychotic. Researchers used the information gathered from this study to treat 40 patients hospitalized for psychotic illness.
In 67 percent of the cases, researchers had identified the best treatment for the hospitalized patients. Malhorta says she would like to increase the odds to 80 percent before publicly marketing the test for use in treatment of schizophrenia or bipolar patients.