Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care (EMBARC)

Madhukar Trivedi, Maurizio Fava, Myna M. Weissman, Patrick J. McGrath, Gerard Bruder, Craig Tenke, Jürgen Kayser, Dan Alschuler, Jorge Alvarenga, Karen Abraham

Up to this point, it has been impossible for psychiatrists to tailor depression treatments to individuals based on personal characteristics. The EMBARC study, a NIMH-funded project taking place at four universities nationwide, is a first step toward such personalized treatment. In this study, we are examining biological and clinical characteristics which may be predictive of antidepressant treatment response in people with major depression. Study participants are treated with either sertraline (Zoloft) or placebo in the first stage of the study, and sertraline or bupropion (Wellbutrin) in the second. Before starting treatment, patients receive a range of tests including both structural and functional MRI brain imaging, electroencephalography (including resting EEG and loudness dependency of auditory evoked potentials), and neurocogntive tests. Participants then repeat the tests after 1 week of treatment. The study aims to examine early biological signs that predict treatment response.