In just a decade, Thalidomide left a devastating mark on an estimated of 100,000 babies worldwide (Meikle, 2016). Deprived of normal life by birth defects, they will involuntarily remain in history as either “casualties” or “survivals” of what will forever be remembered as the “Thalidomide Tragedy”. Thalidomide also tells another story: it is now a life-saving drug used under strict regulations to treat multiple myeloma and leprosy complications.
Thalidomide is an example of why medical testing and individual risk-benefit analysis is performed before prescribing a drug with severe side effects. Today, we find ourselves in a similar, yet more complex situation surrounding medication like antidepressants for teenagers, which often present variable efficacy and a range of side effects (Rikard-Bell et al.,2022). Considered a first-line medication, antidepressants come with a handful of side effects and a ‘black box warning on top of questionable results compared to placebo. This is the story of antidepressant prescriptions for teenagers without backup emotional consolation and social support. This raises the question: can antidepressants for teens be integrated within the same ethical frameworks that guide today's use of Thalidomide?
With the increase in antidepressant prescriptions from 2020 onward (Vogel, 2024), alternative treatments have taken the spotlight in recent years. From prevention-based focused on emotional regulation strategies within the context of culture to intervention-based thinking or physical exercises, we see that new initiatives are ongoing, yet with relative success in treating the spectrum of teenage depression or becoming wide-scale implementations any time soon. Antidepressants, though relatively effective in teen depression, are a floating line for many intervention strategies, whether talking about more traditional treatment pathways, such as CBT, or alternative new interventions (Van Voorhees et al., 2008).
Therefore, one plausible way around this problem is to find ways to increase the efficiency of anti-depressants using AI-monitored dietary choices. AI comes in this story with possible wide-scale implementations in creating possible dietaries and supplement intake suggestions based on the patient line of treatment and blood work if the case.
While anti-depressants traditionally aim to increase the level of monoamines, also known as serotonin and norepinephrine, the improvement in depressive symptoms is often found to take several weeks, yet an immediate increase in monoamines can be observed. As a result, recent research has questioned the sufficiency of the monoamines hypothesis to explain depression and antidepressants. Instead, BDNF levels have been identified as a key mechanism behind antidepressant efficacy. Researchers are now developing new antidepressants, such as ketamine, by directly focusing on increasing BDNF levels through TrkB signaling activation. Following this line of thought, certain amino acids (such as tryptophan and methionine), folic acid, magnesium, and certain Omega-3 fatty acids have been linked with improved SSRI/SSNRI efficiency in controlled trials (Cubillos et al.,2022)
It is important to understand that we are finding ourselves in uncharted territory, standing in front of another great crisis. It is our turn to try to reshape our surroundings to fit our older prospects or reshape the ground of medical ethics to fit our current situation. By adopting AI to personalize dietary recommendations for enhancing dietary antidepressant efficacy, we can take a significant step towards more effective and ethical treatment strategies for teenage depression.
Alexandra Elena Dudu
Footnotes and bibliographies:
therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/ last accessed: September 12th, 2024]
Cubillos, S., Engmann, O., and Brancato, A. "BDNF as a mediator of antidepressant response: recent advances and lifestyle interactions." International Journal of Molecular Sciences 23:22 (2022): 14445.
Meikle, James. "Thalidomide “caused up to 10.000 miscarriages and infant deaths in UK”." The Guardian (2016).
Child Mind Institute. Miller, Caroline. ”Medication for kids with depression”. (2024)
[https://childmind.org/article/medication-for-kids-with-depression/ last accessed: September 12, 2024]
Oxford Languages and Google - English. [https://languages.oup.com/google-dictionary-en/ last accessed: September 12, 2024]
Rikard-Bell, C., Hunt, C., McAulay, C., Hay, P., Morad, A., Cunich, M. and Touyz, S. "Adolescent depression from a developmental perspective: the importance of recognizing developmental distress in depressed adolescents." International Journal of Environmental Research and Public Health 19:23 (2022): 16029.
Van Voorhees, B. W., Smith, S., and Ewigman, B. “Treat depressed teens with medication and psychotherapy.” The Journal of Family Practice 57:11 (2008): 735-9a. Healthline. Vogel, Kaitlin. ”Antidepressant use on the rise among young adults, adolescents.”
(2024). [https://www.healthline.com/health-news/antidepressant-prescriptions-increasing-young-people/ last accessed: September 12, 2024].
Wang, Y., Liang, J., Xu, B., Yang, J., Wu, Z. and Cheng, L. ”TrkB/BDNF signaling pathway and its small molecular agonists in CNS injury.” Life Sciences 336 (2024): 122282
