New Technique Monitors Patients Taking Antidepressants

In the U.S., around 20% of adults suffer from mental health issues. Per the National Institutes of Health (NIH), as of 2020, approximately 52.9 million individuals reported having some mental health complication.

To help with certain mental health problems, many people often take prescription drugs, such as antidepressants, to help with their moods and live healthier lives.

Published on February 6 by Scientific Reports, the biomedical engineering study team from Brown University revealed a new way medical professionals can monitor antidepressants in patients, preventing any potential side effects.

Over the past few years, medical professionals were able to identify specific drugs in our biological samples, such as blood, using a technique referred to as liquid chromatography-tandem mass spectrometry, or LC-MS/MS. The technique, however, requires great biological samples and many steps to analyze the results.

The Brown University research team has now been paving the way to create an effortless version of the LC-MS/MS, which health professionals may broadly use. The study divulges a new way to precisely evaluate and determine eight antidepressants most frequently prescribed to women, including bupropion, citalopram, desipramine, imipramine, milnacipran, olanzapine, sertraline, and vilazodone.

This novel method allows professionals to identify and keep track of these antidepressant drugs from small biological samples — approximately 20 microliters. This process can also be completed by liquid-handling robots, commonly found in clinical mass spectrometry labs.

"We designed our method and put together kits so that once the samples have been collected, they can be put in a computer program for a robotic liquid handler, and all the user essentially has to do is take off the caps, press some buttons, and it will go start to finish," shared Brown Ph.D. student and lead author Ramisa Fariha who is working for a microfluidic diagnostics and biomedical engineering laboratory led by Brown professor Anubhav Tripathi.

When the gathered samples are prepared, they process through a mass spectrometer, which then identifies the sample into minuscule particles that reveal the drugs. The precision of the method is similar to other LC-MS/MS procedures. It has the benefit of utilizing only a small amount of samples that can be easily handled by liquid-handling robots.

This new method can be expected to be used in many clinical environments to guide the effectiveness of drugs in patients, especially women undergoing postpartum depression.

“We have made a very big step,” said Brown University professor and the lab’s principal investigator Tripathi. "For clinical lab adaptation, you want to reduce the error by humans. The more you automate, the more robustness you get and the more trust there is from doctors."

How common is depression in the U.S.?

Depression is a common mental health issue affecting more than 21 million Americans every year, according to Mental Health America. It affects not only adults but also 15% of youths.

This issue can severely hinder one's daily life, causing a myriad of symptoms from weight loss, to suicidal thoughts, and fatigue. Despite the severity of depression, it can be monitored with the proper treatment and support, from therapy to prescription drugs. Women are more likely to struggle with depression omen than men, with around 12.5% of U.S. women experiencing depression.

How can clinicians use the new method?

Currently, there is no commercial item in the U.S. for health professionals that can detect the number of antidepressants present in their patients. For this reason, they have to utilize qualitative procedures, such as surveys, to measure their symptom and standing. The Brown research team created a method that clinicians could use widely without needing many samples.

They used a JANUS G3 Robotic Liquid Handler for their study but said professionals could use other machines to utilize the new method. "Every time our lab and our team publishes a paper, we go into the nitty gritty so our results can be easily replicated by others," said Fariha.

The team developed prototype kits that clinicians can use in their labs to employ the method.

In addition to the necessary chemicals and solvents, the kits come with a comprehensive instruction manual outlining what clinicians should search for based on their own experiences and the many changes they made during the quality control process.

The team intends to work on oncology automation projects like creating a kit that could detect ovarian cancer.