Measuring brainwaves while sleeping can tell if you should s
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Scientists have discovered that measuring brainwaves produced during REM sleep can predict whether a patient will respond to treatment from depression. This enables patients to switch to a new treatment rather than continue the ineffective treatment (and the depression) for weeks without knowing the outcome.

The standard treatment is antidepressants, normally Selective Serotonin Reuptake Inhibitors (SSRI's), such as Prozac and Fluoxetine. However, these can take weeks or months to show an effect. Around 50% of sufferers don't respond to initial antidepressant treatment. Thus doctors have to change treatment strategy, and again have to wait for response for another four weeks.

A randomised controlled trial on 37 patients was conducted with Major Depression. All were treated with antidepressants, but 15 were assigned to the control group, while the remaining 22 had their details given to the psychiatrist in charge of treatment. All then had their brainwaves monitored during REM sleep (technically, this was a measurement of prefrontal theta cordance in REM sleep). The overall aim was to see a 50% reduction in symptoms of depression.

Doctors tested patients as early as one week after starting treatment. Those patients who were unlikely to have successful treatment were immediately switched to a different treatment. After 5 weeks it was found that 87.5% of these patients had an improved response, as opposed to just 20% in the control group. Researchers said that by predicting the non-response to antidepressants they were able to adapt the treatment strategy more or less immediately. Patients need to be in a situation where their REM sleep can be monitored, so this requires more care. It means that psychiatrists may be able to treat the most at-risk patients, for example those at risk of suicide, much quicker.

The study results presented are interesting and suggests that it may be possible to tell if a treatment is working much more quickly—even after a week of treatment—by using a physiological measure of response (REM sleeping pattern). If this is replicated in larger, blinded study then it would have enormous implications for the future treatment of individuals with depression.