Helping Students Access Care Quickly Through Research

Major depression is a serious medical illness that can significantly affect the success and overall well-being of college students. Students with depression may experience some or all the following symptoms:

• Feeling sad or empty
• Losing interest in their favorite activities
• Eating and sleeping more or less than they usually do
• Feeling hopeless, irritable, anxious, or guilty
• Having physical symptoms such as aches, pains, tiredness, headaches, cramps, or digestive problems
• Thinking about death or suicide

Many students experiencing a depressive episode can receive help through therapy at student counselling centers, and/or by taking an antidepressant prescribed by their primary care doctor. However, sometimes these initial treatments may not lead to significant symptom improvement.

In clinical practice, once patients have tried two treatments without symptom improvement, their depression is referred to as “treatment-resistant”. At this point, they may schedule an appointment with a psychiatrist. However, it can often take months to schedule an initial evaluation. This is one area where research studies can help to fill the gap, since research patients can usually obtain an appointment within 1 week.

Massachusetts General Hospital is leading a treatment resistant depression study funded by the Patient Centered Outcomes Research Institute (PCORI). PCORI is a nonprofit organization authorized by Congress to fund comparative clinical effectiveness research. PCORI’s mission is to produce reliable, useful information that will help patients, family caregivers, clinicians, employers, insurers, policy makers and others make better-informed health and healthcare decisions. The study is investigating three strategies that are commonly prescribed as a next line of treatment in patients with treatment-resistant depression: 1) Switching to another antidepressant, 2) adding another medication to the current antidepressant, and 3) adding rTMS (repetitive transcranial magnetic stimulation) to the current treatment. The study includes 8 weeks of treatment including weekly visits to the clinic, and all treatments provided in the study are FDA approved to treat depression. If their symptoms improve, patients may continue the treatment after the study under the supervision of their doctor.

The study currently has sites open in the following locations:

• Massachusetts General Hospital (Boston, MA)
• University of Texas Southwestern (Dallas, TX)
• New York University (New York, NY)
• Stanford University (Stanford, CA)
• University of Alabama and Birmingham (Birmingham, AL)
• University of Virginia (Charlottesville,VA)
• University of Pennsylvania (Philadelphia, PA)
• Kansas University Medical Center (Wichita, KS)
• Baylor University (Houston, TX)
• Sheppard Pratt Health System (Baltimore, MD)
• Roper Saint Francis Healthcare (Charleston, SC)
• Saint Boniface General Hospital (Winnipeg, Canada)
• University of British Columbia (Vancouver, Canada)

If you feel that this study could be a resource for your students, we encourage you to reach out to us at mmartinson@mgh.harvard.edu and we would be happy to answer questions and explain the study in more detail.