Who Does It Help? It's a Good Question in Mental Health CareHow genetic and biological subgroups are changing evaluations of antidepressants
- GAB NEWS
- 14 hours ago
- 2 min read
When it comes to treating mental health conditions like depression, the most common question, whether in a doctor’s office or a research lab, is still: Does it work? That’s understandable. We all want to know if a treatment helps people feel better.
But increasingly, there’s a more useful question we should be asking: Who does it work for?
Most antidepressants today are tested in large, mixed populations. The results reflect the “average” effect across that group. But depression isn’t one condition; it’s likely many conditions that look similar on the outside but differ biologically. That means a treatment that helps one group might not help another. And when we average the effects together, we may miss the fact that it worked really well for a specific group.
This is where subgroup analysis comes in. It’s a way for researchers to look at how different types of people respond to a treatment based on biology, genetics, or other meaningful traits. Done right, this approach doesn’t weaken the science; it strengthens it. It allows us to stop thinking in averages and start thinking in individuals.
Take a recent example from a study I was involved in. Researchers tested an experimental treatment for major depression, and while the overall results were positive, the most compelling finding was that a particular subgroup, defined by a genetic marker linked to the body’s stress system, had a faster and stronger response than everyone else. The difference was seen within the first week and continued to grow over the treatment period.
That’s a big deal. Not just because it might lead to a new treatment, but because it shows how we can use biology to match people to the therapies most likely to work for them. It’s a step toward more personalized mental health care—something that’s been common in cancer treatment for years but has been slower to take hold in psychiatry.
Of course, there are important caveats. Subgroups have to be identified in advance based on sound science, not cherry-picked after the fact. Findings should be repeated in other studies. And any treatment, no matter how well-targeted, must still be safe and tolerable.
But if we can identify even one group of people—say, 25 or 30 percent of those with depression—who are likely to respond to a specific treatment within a week, that’s not a minor detail. That’s potentially life-changing. It could reduce the months (or years) that some patients spend cycling through medications that don’t work.
This is not about abandoning broad-acting treatments or replacing traditional antidepressants. It’s about giving patients and clinicians another tool, one that’s grounded in biology, not just guesswork.
Psychiatry doesn’t need to reinvent itself overnight. But we do need to keep evolving. Asking who a treatment works for might help us stop discarding potentially valuable options too soon—and start finding the right ones faster.
References
HMNC Brain Health. (2025, August 5). HMNC Brain Health announces Phase 2 results from OLIVE trial in major depressive disorder (MDD) with genetically guided precision approach. GlobeNewswire.
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