Researching for Hope
Photography by Wes Battoclette
What if you knew how to help a patient but couldn’t take the steps for 17 years? This is the case for many research teams nationwide. That’s because there’s a historic 17-year lag time between research findings and integration with diagnosis and treatment. But at the Lindner Center of HOPE in Mason, research informs patient care every day.
That’s because the Lindner Center of HOPE has both world-class research and clinical programs – experts are both researching cutting-edge treatments and actually treating patients.
“There are a number of important reasons to have a research program while you’re treating patients,” explains Susan L. McElroy, M.D., chief research officer for the Lindner Center of HOPE who is known internationally for her research in bipolar disorder, eating disorders, obesity, impulse control disorders and psychopharmacology. “One of the most important reasons is that you’re able to bring new findings to the clinical arena sooner rather than later. There’s often a lag between discovering something and it reaching into clinical work. Research helps us stay cutting edge in terms of diagnosis and treatment.”
Since opening, the Research Institute at Lindner Center of HOPE has received more than 40 grants totaling approximately $3.5 million. In affiliation with the University of Cincinnati College of Medicine, the research team conducts advanced research in genetics, brain imaging, psychopharmacology, psychotherapy and more. This research provides new methods to diagnose and treat common mental illnesses.
One example of such research is a study Dr. McElroy did with the company Naurex (now called Aptinyx). “We studied an intravenous study medication for people with depression,” explains Dr. McElroy, “that targets a different receptor in the brain than other antidepressants target. What’s exciting is, not only did it work, but it worked within 24 hours. I never thought I’d live to see that. It’s extremely exciting.”
During the study, at the highest and most effective dose, the antidepressant efficacy at 24-hours was more than double the effect seen with most other antidepressant drugs after four to six weeks of repeated dosing.
“It’s been fascinating to see patients who have suffered with depression for years, and we do something and they leave as a different person,” says Anna I. Guerdjikova, PhD, LISW, CCRC, part of the Lindner Center research team and a staff licensed social worker.
Another important study is a collaboration with the Mayo Clinic. “We are establishing a large-scale genetic biobank of bipolar disorder,” says Dr. McElroy. “It’s different than other genetic studies of bipolar disorder in that people are extremely well-characterized. In other words, we carefully phenotype an individual’s bipolar disorder, and evaluate important symptoms such as prior suicide attempts and psychosis, as well as co-occurring disorders like obesity, heart disease, anxiety disorders and drug use. Bipolar disorder is one of the most genetic illnesses of mankind – 70 percent is genetic – and building a biobank this way will help us identify some of the missing heritability.”
The progress so far is promising. “It’s going very well – we have controlled for body mass index, and no study had ever controlled for BMI before,” explains Dr. McElroy. “By doing that we identified a gene that is potentially an important part of the heritability of bipolar disorder. That gene is important in Type 2 Diabetes and the development of the nervous system. And we’ve been able to replicate our finding, which is very difficult to do in genetic studies.”
This identification of genetic risk factors associated with disease onset could potentially lead to early intervention in at-risk patients or even lead to preventative measures. It could also help indicate the best treatments for individual patients.
The Research Institute is also studying ways for patients with bipolar disorder to self-manage their illness. “Self-management is becoming an increasingly important approach in helping people take care of themselves when they have a chronic illness,” says Dr. McElroy. “We are looking at self-management in people who have bipolar disorder. There are a growing number of apps where people can record their sleep, their mood, their energy to help them manage their illness. We’re doing a study where interested Lindner Center of HOPE patients with bipolar disorder are randomized to a standard app that records symptoms but doesn’t offer feedback, or to an app records symptoms and provides feedback – for example; if things are going really well and the individual is stable, the app might say consider adding this exercise to your regimen; if things aren’t going very well it might suggest you see your healthcare provider.”
At any given time, the research team is working on seven to 12 studies. This is a great opportunity for people in the TriState to get involved – both to potentially receive treatment themselves but also to further medical research worldwide.
“We provide cutting-edge treatment,” explains Dr. Guerdjikova, “and taking part in a study is a great chance for people to get information, get education and possibly get treatment.”
If you are interested in taking part in a clinical trial, visit the Lindner Center of HOPE website, click research and select “clinical trials.” Some active research studies include bipolar disorder (manic depression) studies, major depression, eating disorder studies and smoking cessation, but studies are subject to change and may be updated at any time.
“We offer a very thorough evaluation, both psychiatric and medical,” says Dr. McElroy. “Participants get education about their condition and some of our studies have open label extensions, which means even if you had a placebo in the first part of the study, you may still be able to receive treatment in the second part of the study. After the study, we do our best to provide referrals for 100 percent of the participants. Once an individual has been part of a study, that individual has received an accurate diagnosis, and we can help them find a treatment provider.”
Whether you are currently a patient of the Lindner Center of HOPE or not, you may be eligible to participate.
Even if the Lindner Center of HOPE doesn’t have a study that fits your condition, Dr. Guerdjikova suggests visiting www.clinicaltrials.gov – a database that includes information about both publicly and privately supported clinical studies of human participants around the world.
“In the last 25 years, there’s been great momentum in the field of mental health research,” says Jennifer Pierson, senior director of Marketing and Outreach for the Lindner Center of HOPE. “Lots of other areas of medicine have been advancing and mental health has really been coming from behind, but we’re on a roll. There’s been a landslide of success and exciting innovation and our researchers and study participants are living it.”
For more information about the Research Institute at Lindner Center of HOPE, visit www.lindnercenterofhope.org and click “research.” Or, call 513.536.HOPE (513.536.4673).