How is OBI bringing lab to life > Collaborative research and partnerships + New knowledge and understanding of brain disorders

“Depression can be overwhelming – a person is not just lazy or not getting their act together – it’s like a dark cloud hovering over you and something as simple as brushing your teeth is overwhelming. It slowly affects your work, income and family, which is why it’s such a huge societal problem”, says Andrew Kcomt, Knowledge Translation & Research Manager, Mood Disorders Association of Ontario. “As a healthcare professional, the rational part of my brain knew what I had to do and how to navigate through this, but as a person living with depression, I was just overwhelmed by it all – there were days where I gave up and had no hope.”

There are many factors like family history, genetics and life experiences, such as childhood trauma or the current pandemic, that can lead to depression. There is also no single type of depression. Every individual is unique, and it affects everyone differently. With depression being the leading cause of time away from work and a major risk factor for suicide, it is critical to get individuals matched with effective treatments faster, yet the variability of depression makes this hard to do. As such, we need to develop new ways to treat individuals who don’t respond to traditional depression treatments.

CAN-BIND, (OBI’s depression research program) brings together experts from across the country with the goal of delivering prompt treatments tailored for the individual. One of their successes has been the identification of a biomarker, the protein GPR56, which has shown to be consistently associated with depression and antidepressant response. Biomarkers are used as an indicator of a disease or disorder and may include everything from pulse, blood pressure, blood samples, x-ray results, CAT scans or changes in the brain that can aid in early detection.

“As a researcher it is important for me to think outside-of-the-box. We still do not understand how antidepressants work and cannot predict on whom they will work,” says Dr. Gustavo Turecki, Psychiatrist, McGill University and the lead investigator on this new discovery. “By studying biomarkers, we can gain insight into mechanisms by which antidepressants work, identify new avenues for treatment, and determine the right treatment for the right person in order to help individuals with depression get well quickly, and stay well.”

“By studying biomarkers, we can have insight into mechanisms by which antidepressants work, identify new avenues for treatment, and identify the right treatment for the right person in order to help individuals with depression get well quickly, and stay well.”

Dr. Gustavo Turecki, Psychiatrist, McGill University

The study found that the levels of GPR56 mRNA (a gene) change following the administration of antidepressants, both in the blood and the brain. In addition, when changing the levels of this gene in animal models of depression, the researchers observed effects similar to those of antidepressants. This is a promising biomarker to further explore given its potential as a predictor of depression and an individual’s response to treatment.

This study is all the more meaningful as the identification of this biomarker was facilitated through collaboration with one of our industry partners – something OBI strongly advocates for to accelerate research and spur innovation. Lundbeck provided a donation of valuable biosamples and research funds to the CAN-BIND program to support this work, which gave researchers a running start in this complex biomarker analysis.

Another ground-breaking study by the CAN-BIND team will compare ketamine with electroconvulsive therapy in the treatment of depression. Clinical trials with ketamine have shown that its antidepressant effects are rapid, usually working within a few hours to a day after a single infusion. Evidence also shows that repeated administration of ketamine infusions can elicit sustained and even cumulative antidepressant effects - a 50 percent decrease in patients’ symptoms.

“In medicine, it’s always a question of risk and benefit. The risks of using ketamine are really minimal, but the benefits are enormous — especially since we know what the risks of persistent depression are. It’s basically a neurodegenerative disease. If you have chronic depression, you have more chances of developing Alzheimer’s disease prematurely. And of course, there’s always the catastrophic outcome of depression, which is suicide”, says Dr. Pierre Blier, Royal's Institute of Mental Health Research, University of Ottawa.

Based on these results, CAN-BIND initiated a study to evaluate the safety and effectiveness of ketamine as compared to electroconvulsive therapy. Researchers think ketamine may have fewer side effects, cost less, require fewer health care resources, fewer outpatient visits and less inpatient hospitalization. This study builds research into regular clinical care and its findings will help develop treatment options for those with a major depressive disorder who have not responded to any other treatments.

CAN-BIND’s mission is to deliver fast and effective care to all Canadians living with depression. Through collaboration, research innovation and systems-oriented thinking, we seek to discover treatment strategies guided by each individual’s biology.

“To people living with depression I would say, don’t give up hope” says Kcomt. “There is a lot of research happening in depression and there are lots of care options available. The first step is to understand your options and then talk with your loved ones and your healthcare providers to find the right one for yourself.”

Learn more on research from CAN-BIND, check out The Choice–D Patient And Family Guide To Depression Treatment and hear first-hand, the positive impact ketamine treatment has had on one patient’s life on CAN-BIND’s podcast.