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New type of depression discovered—and it’s not helped by drugs

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When it comes to depression, there’s no one-size-fits-all.  Researchers have just defined a new subcategory of the condition—cognitive biotype.

Scientists at Stanford University say that cognitive biotype depression accounts for 27 percent of all cases of depression, and it’s not helped by antidepressants.

The cognitive biotype patient can’t plan, has little self-control, can’t stay focussed and can’t suppress inappropriate behaviour.

The researchers assessed the effectiveness of two typical antidepressants—Lexapro (escitalopram) and Zoloft (sertraline)—on a group of 1,008 adults who suffered major depression, but who hadn’t been given any drugs to treat it.

The participants were tested before and after they had taken the drugs, and 96 of them also had their brains scanned with fMRI (functional magnetic resonance imaging) while they were carrying out simple tasks.

The researchers found that 27 percent of the participants had more marked cognitive slowing and insomnia, poorer cognitive functioning in behavioural tests, and there was reduced activity in several areas of the brain.

This sub-group—which the Stanford researchers described as cognitive biotypes—were also helped less by the antidepressants; around 38 percent reported improvements compared to 47 percent of those with more typical depressive symptoms.

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References
JAMA Network Open, 2023; 6: e2318411
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