Australian Scientists Lead Research Into Targeted Psychiatric Treatment

Australian Scientists Lead Research Into Targeted Psychiatric Treatment
University of Western Australia (Adwo/Adobe Stock)
Steve Milne

Australian scientists are helping to develop a new way to determine which mental health drugs are best for patients based on their metabolic profile.

Led by Prof. Sean Hood, the head of University of Western Australia’s (UWA) School of Psychiatry, and working in combination with U.S. mental health technology company Prairie Health, the study will evaluate how genetics impacts the type of medication chosen to treat anxiety disorders.

Prairie Health, a California based company that assists people with anxiety and mood disorders to get personalised mental health care, is pioneering the routine use of genetic profiles of metabolic pathways to guide which antidepressants are most suited to individual patients.

They have found that two thirds of adults in need of treatment were previously treated with medications that would not have been prescribed had the person’s metabolic profile been known.

“Choosing medications matched to a patient’s profile can improve their experience by reducing side effects and producing a faster time to treatment response,” Hood said in a release on Friday.

The partnership will provide access to UWA populations to assist Prairie Health in the development of advanced predictive models, with the objective of developing new clinical approaches that support precision psychiatry.

According to Health Direct, while doctors will prescribe an antidepressant based on a person’s symptoms or disorder, people respond differently to different drugs, so it may be necessary to trial more than one antidepressant to find out what works best for the person and produces fewer side effects. Some side effects may include weight gain, nausea, headaches, diarrhoea or constipation, a dry mouth, insomnia, dizziness, or sweating.
Bottles of antidepressant pills named (L-R) Wellbutrin, Paxil, Fluoxetine and Lexapro are shown photographed in Miami, Florida on March 23, 2004. (Photo Illustration by Joe Raedle/Getty Images)
Bottles of antidepressant pills named (L-R) Wellbutrin, Paxil, Fluoxetine and Lexapro are shown photographed in Miami, Florida on March 23, 2004. (Photo Illustration by Joe Raedle/Getty Images)

President of the National Association of Practising Psychiatrists, Prof. Phillip Morris AM, told The Epoch Times that this relatively new area of personalising psychiatric treatment shows promise.

He said cytochrome P450 enzymes in the liver are responsible for most of the metabolising of various drugs.

“If we’re giving a patient say an antipsychotic or antidepressant drug and they had characteristics of a very high metabolism of that drug based on their cytochrome P450 characteristics, a standard dose may actually be too little because they’ve got a very high metabolism of the drugs,” he said.

“They might need quite substantially more medication to have the effect of the drug because it’s being metabolised so quickly.”

On the other hand, he added, if the person has very few of the enzymes to metabolise a drug, a standard dose might be too high or even toxic.

“So knowing about characteristics of the patient’s metabolism with respect to drugs ... would probably be able to inform doctors as to what the doses might be and also what to expect in terms of side effects,” he said.

Morris noted that there are tests available for this, but they’re very expensive and not covered by Medicare, so they’re not used in routine treatment.

He said that there is going to be a lot more work done to make these tests more easily available and interpretable as currently many doctors that might consider using this technology may not know a lot about the P450 system and how they can interpret the results in a simple and meaningful way.

“At the moment, it’s limited to doctors who have a particular interest, who feel that they’re comfortable interpreting certain results,” he said.

“What will need to happen is that there'll need to be further development of the tests and then marketing of the tests in a way that both patients and doctors understand the results.”

Morris also emphasised that before such tests can be covered by Medicare, there will need to be studies that confirm they make a difference compared to routine treatment based on the physician’s judgement.

“I think it’s all very positive. It’s just a question of the profession understanding the merits of this application in a practical and easy way for patients, and then determining that it actually does make a difference in terms of the practice of psychiatry, and therefore does make a difference in terms of patients’ recovery or side effects,” he said.

Steve is an Australian reporter based in Sydney covering sport, the arts, and politics. He is an experienced English teacher, qualified nutritionist, sports enthusiast, and amateur musician. Contact him at [email protected].
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