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Antidepressants can be very effective in treating depression, but the drugs are often a hit or miss; of the 10% of Americans diagnosed with depression, the medications generally work in about half of cases. Even then,finding the right antidepressantcan often take months of cycling through different drugs until one starts to alleviate the mood disorder.

 

But in a study published in the Proceedings of the National Academies of Science, researchers led by Leanne Williams, professor of psychiatry and behavioral sciences at Stanford University, found that a combination of brain scans and assessment of early life stress can predict which people are more likely to respond to an antidepressant right from the start.

Williams and her colleagues scanned the brains of 80 people with depression using functional MRI, which allows scientists to see which parts of the brain are active while people are seeing specific objects in the MRI machine. In this case, Williams was interested in analyzing the amygdala, a part of the brain involved in emotional processing. Animal studies and previous human studies have linked certain levels of activity of this brain region with mood disorders. The volunteers were shown pictures of happy and sad faces, and Williams recorded their amygdala responses to each.

 

She also asked them questions about their childhood experiences to determine how much stress or trauma they have been exposed to from an early age. Losing a loved one, having an illness, experiencing family conflict or being exposed to neglect or abuse can all affect how the brain—particularly the emotional brain—develops.

 

All of the people were randomly assigned to one of three popular antidepressants, each of which works in a different way in the brain, for eight weeks. After this, their brains were scanned again. Those who showed more amygdala activity when they saw happy faces were most likely to have good responses to antidepressants, while those with less activity—and therefore less ability to recognize and feel happiness—were not as likely to benefit from the drugs.

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TIME

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