A groundbreaking advance in translational medicine from UT Southwestern that uses a drop of blood to measure an inflammatory protein promises a faster, more personalized path to effective treatment for depression.

The study by Dr. Madhukar Trivedi (front) demonstrated that measuring a depressed patient’s C-reactive protein level can help physicians prescribe an antidepressant that is more likely to work.

Without a simple, data-based approach to diagnosing depression in the primary care setting, treatment is often delayed. A patient may try multiple therapies before seeing results in a process that can take months, or years.

“Currently, our selection of depression medications is not any more superior than flipping a coin, and yet that is what we do. It’s a lot of trial and error. Now, we have a simple biological test to guide treatment of depression,” said Dr. Madhukar Trivedi, Director of the Center for Depression Research and Clinical Care, a cornerstone of UT Southwestern’s Peter O’Donnell Jr. Brain Institute.

“In our study of more than 100 patients published in Psychoneuroendocrinology, we found that C-reactive protein (CRP) levels from a finger-prick blood test were associated with much higher remission rates if we matched patients with the right medication,” Dr. Trivedi said. C-reactive protein is a well-known inflammatory marker linked to increased risk for heart disease.

For patients whose CRP levels were less than 1 milligram per liter of blood, the study showed, the drug escitalopram alone was more effective than the therapeutic bupropion. For patients with higher CRP levels, therapy with both drugs was more likely to work. This work and more in the Center for Depression Research and Clinical Care has been supported by $5 million gifts from both the Hersh Foundation and the W.W. Caruth, Jr. Foundation.

“These findings provide evidence that a biological test can immediately be used in clinical practice,” said Dr. Trivedi, a Professor of Psychiatry who holds the Betty Jo Hay Distinguished Chair in Mental Health and the Julie K. Hersh Chair for Depression Research and Clinical Care.

UT Southwestern’s Center for Depression Research and Clinical Care was established with a gift from the Hersh Foundation to accelerate new discoveries into the causes and treatment of depression and mood disorders.

The next step is to conduct larger studies to verify CRP’s role with other antidepressants and find alternative markers where CRP does not prove effective.