Yueju Pill or escitalopram in MDD？

Major depressive disorder (MDD) is a serious mental health condition and is expected to become the most common and costly illness worldwide by 2030. Although treatments for depression have improved, there is still a lack of clear, objective ways to choose the best antidepressant for each individual, as nearly one-third of patients do not respond to their initial antidepressant. A recent study published in General Psychiatry explored the efficacy of traditional Chinese medicine (TCM) in the treatment of MDD. Importantly, this study also disclosed the brain network from MRI imaging that is capable to predict the improvement on the symptoms or the blood biomarker by the treatment.   

This study was a randomized, double-blind, placebo-controlled trial involving 28 outpatients with MDD from the Fourth People’s Hospital of Taizhou. Participants were randomly assigned to one of two groups, the Yueju Pill group (which received Yueju Pill and a placebo for escitalopram), or the escitalopram group (which received escitalopram and a placebo for Yueju Pill). Researchers collected data on depression symptoms, as measured via 24-item Hamilton Depression Scale (HAMD-24) scores, peripheral blood samples and MRI brain scans.

Both groups showed improvement in their depression symptoms after treatment. However, only the Yueju Pill group showed a significant increase in serum brain-derived neurotrophic factor (BDNF)—a protein associated with brain health and mood regulation. From the brain imaging results, researchers found that certain brain structure networks could predict changes in depression scores for both groups. Interestingly, some specific brain network patterns—based on sulcus depth and cortical thickness—were only predictive in the Yueju Pill group. Further analysis showed that the visual network of the brain played an important role in predicting both changes in depression scores and BDNF levels for those taking Yueju Pill.

This study suggests that brain network patterns could help predict how well individual patients with MDD respond to Yueju Pill treatment. This finding may help clinical workers personalize antidepressant therapy in the future.

“The brain networks can then be fed to the predictive models constructed in this study to predict patients’ responses to Yueju Pill treatment,” explained Dr. Zhang, the study’s leading author. “Based on the predicted responses, we can then determine whether the patient is suitable for Yueju Pill treatment.”