The lack of any biological or genetic predictors of clinical utility of specific medication for Major Depressive Disorder (MDD) results in random first choice and costly systematic follow-up assessment. Given the lifetime prevalence in the US estimated at 17% this empirical approach translates into millions of people going through months of ineffective medication increasing the morbidity and the cost of treatment (in 2000 the burden of depression in US was ~$83 billion). Here we propose a reliable in vitro test to predict the best existing drug for the new patients with MDD. Recent genetic studies suggested that genetic determinants are responsible for variable response to antidepressant. Therefore we put forward an in vitro assay based on the patient-derived neurons to measure and classify the variable response to antidepressant. We combined a state of the art techniques and entirely novel computational algorithms to build a reliable in vitro diagnostic platform to predict the best 1st choice antidepressant for each patient with MDD. In the future, this approach could be adapted to other psychiatric disorders.
Statement of Benefit to California:
The lack of any biological or genetic predictors of clinical utility of specific medication for Major Depressive Disorder (MDD) results in random first choice and costly systematic follow-up assessment. Here we propose a reliable in vitro test/diagnosis methodology to predict the best existing drug for the new patients with MDD. An effective, straightforward, and understandable way to describe the benefits to the citizens of the State of California that will flow from the stem cell research we propose to conduct is to couch it in the familiar business concept of “Return on Investment”. The novel therapies and reconstructions that will be developed and accomplished as a result of our research program and the many related programs that will follow will provide direct benefits to the health of California citizens. In addition, this program and its many complementary programs will generate potentially very large, tangible monetary benefits to the citizens of California. These financial benefits will derive directly from two sources. The first source will be the sale and licensing of the intellectual property rights that will accrue to the state and its citizens from this and the many other stem cell research programs that will be financed by the CIRM. The second source will be the many different kinds of tax revenues that will be generated from the increased bio-science and bio-manufacturing businesses that will be attracted to California by the success of the CIRM.