New trends in personalized treatment of depression

Abstract

Purpose of review Major depressive disorder (MDD) is a common and burdensome severe mental disorder, which is expected to become the leading cause of disease burden worldwide. Most patients with MDD remain untreated/undertreated. For many decades “a trial and error” approach has been adopted for selecting the best treatment plan for each individual patient, but more recently a personalized treatment approach has been proposed, by taking into account several individual and clinical factors (e.g., clinical stage, comorbidity, duration of illness). Therefore, the aim of this study is to address the most relevant innovations in the personalized treatment plan for patients with MDD. Recent findings In recent years, several pharmacological and nonpharmacological innovations have been introduced in the treatment of patients with MDD. As regards pharmacological treatments, the newly developed drugs have an innovative mechanism of action, targeting the glutamatergic systems. These drugs are highly effective in improving depressive symptoms, with a good level of safety and tolerability. As regards nonpharmacological interventions, innovations include both new strategies targeting different domains (e.g., lifestyle interventions aiming to improve the physical symptoms of depression or virtual reality) and classical interventions provided through innovative mechanisms (e.g., web-based psychotherapies and use of digital approaches). Patients globally report a good level of acceptability of these interventions. Summary Depression is a heterogeneous, complex and multidimensional disorder, representing one of the leading causes of disability worldwide. The final aim of the management of patients is functional recovery, which can be achieved by using personalized, integrated and recovery-oriented interventions. Several innovative pharmacological and nonpharmacological treatments are now available; interventions should be selected on the basis of the patient's needs and preferences in order to tailor the treatment, according to a shared decision-making approach.

A Habenula Neural Biomarker Simultaneously Tracks Weekly and Daily Symptom Variations during Deep Brain Stimulation Therapy for Depression

“…Population-level neural biomarkers are derived from data collected from several patients and have the benefits of being directly applicable to a new patient and robust interpretability of the neural biomarker's biophysical mechanism across patients [31]. By contrast, personalized neural biomarkers are derived from data collected from an individual patient, which is more powerful in capturing the unique characteristics of depression symptoms in each patient, especially given the large inter-individual variability in depressionrelated brain networks [56]. With the emerging capability of recording more data within a single patient using mobile devices, personalized neural biomarker models can be more accurate in tracking the temporal dynamics of depression symptom variations.…”

Effectiveness of Group Physical Exercise in Treating Major Depressive Disorder: An Analysis of Secondary Data from an Aborted Randomized Trial

“…Individualized treatment plans are common for MDD patients, as different people may react differently to a given set of therapies. When creating a treatment plan, medical professionals consider variables including the patient’s preferences, the degree of their depression, and any contraindications [ 9 , 10 ]. A meta-analysis adjusting for publication bias concluded that “exercise has a large and significant antidepressant effect in people with depression” [ 3 , 11 ].…”

Mood and anxiety disorders: a challenge for mental healthcare systems in a changing world

“…In particular, the clinical picture of major depressive disorder may portray itself in heterogeneous ways. Sampogna et al [4] present new therapeutic options emerging as alternatives for patients who have not responded to previously used treatments or have been unable to continue them due to side effects. The authors also draw attention to individual factors and those related to the course of previous treatment, which may be relevant to the choice of appropriate treatment.…”