Article archive / March 1, 2013
Originally published: . Volume 4, No. 7. Source pages: 9.
Making national headlines in NY Times, Huffington Post and Fox News is a company that provides an objective, physiologically based measure using EEG results and norms to help doctors and nurses choose the right medications for their patients.
The method is called the Psychiatric EEG Evaluation Registry, or PEER Report, and it compares features of the patient’s EEG patterns to a database of others with known characteristics, and then provides a complex quantitative analysis to guide the clinician. The online database, developed by physicians, allows medical professionals to exchange objective, statistical neurophysiology-based data on individual patient medication response and outcomes. Physicians use the information to aid treatment of anxiety, ADD, depression, bipolar, addiction and other behavioral disorders. It gives clinicians a heads-up about specific medications for certain patients.
In a number of recent retrospective studies the PEER Report was shown to be of value in identifying medications that caused adverse events for a patient.
The Times spoke with Dr. David Thomason, a medical prescriber practicing in Monroe, Louisiana, who is part of the network of providers trying out this new technology, and the only person listed in Louisiana by the company, CNS Response, Inc.
“This is a data-referenced tool,” Dr. Thomason explained. “I haven’t used it that much, but it looks at data from an individual’s EEG to help predict responses to medications. The developers analyze the EEG and they send back a report with recommend- ations that can help guide the use of medications.” Thomason also said he uses other tests also to help guide his decisions regarding medications with his patients. Finding the exact right medication and dose can be one of the most difficult issues for the healthcare professional and the patient, explained George Carpenter, CEO of CNS Response, the company who provides the analytical tool for clinicians and researchers.
“There is no denying that today's mental health care treatments are producing poor results. In fact, only 12.7% of Americans receive ‘minimally effective’ treatment according to government studies,” Carpenter wrote in Huffington Post this last December. “We must do better. We can't afford to accept treatment failure in mental health any longer. While civic leaders look for solutions, they should also accelerate new technologies that are offering promising answers to help those with mental disorders get the right medications.”
There are more than 130 drugs for those with behavioral and psychological problems, and because medications affect different people differently, there is a real and ongoing problem of which approach is best. The most common result has been that doctors try drugs in a trial-and-error process, which is not only ineffective and frustrating for the client, but often dangerous. Patients are often misdiagnosed and/or prescribed a drug to which they are treatment-resistant or that worsens the condition.
Researchers reporting results of a retrospective analysis of patients using the PEER results, published a June 2012, article in Neuropsychiatric Disease and Treatment article. “A large body of the recent psychiatric literature is questioning the empirical value of current prescribing habits,” write the researchers, “as well as the psychiatrists’ choice of medication selection as increasing amounts of polypharmacy and risk of medications creep into patients’ regimes. Without better evidence- based research, often medication choices are made by trial and error, leading to significant delays to effective treatment.” And the authors noted, “There is little empirical evidence supporting the benefits of polypharmacy, and continuing a trial-and-error approach to the implementation of psychotropic medications.”
Considering that the majority of patients with mental health issues show no response, partial response, or temporary response to pharmacotherapy, a better approach has been long overdue, say the PEER developers. Trial and error prescribing is costly and most of all it can be harmful. Better matching of patient with medication can save time and money and avoid patient suffering.
The company notes that the technology has demonstrated good success with clinical outcomes 2 to 3 times better than the current trial and error treatment. Walter Reed National Military Medical Center begins using the technology in a 2,000 soldier pilot program in early 2013, according the company spokes person, George Carpenter.
Some reviewers feel the approach to be especially helpful with treatment resistant individuals.
Studies have also indicated that third party payer outcomes improved also, with a shorter time for the patient to stabilize and significantly fewer required office visits. CNS Response’s Psychiatric EEG Evaluation Registry, or PEER Online is a cloud-based platform, which allows doctors to exchange outcome data referenced to their patients’ neurophysiology. The advantages included cautions against using certain medications with potentially adverse events for a given patient, and a quicker path to recommending those medications that have shown positive results with those patients with similar brainwave patterns. For more information, go to www.cnsresponse.com <http://www.cnsresponse.com>
Dr. David Thomason Example of QEEG images of brain maps. The different colors indicate abnormality in different areas of the brain. The new, data-referenced method helps to predict patients’ response to medications, cutting down on trial-and-error approaches.
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